基于“诸呕吐酸,皆属于热”理论探究清热降逆法治疗胃食管反流病  

Exploration on the treatment of gastroesophageal reflux disease by clearing heat and descending the adverse flow of Qi based on“all acid eructation is ascribed to heat”

作　　者：张雪薇 文卫 李镇 ZHANG Xuewei;WEN Wei;LI Zhen(Digestive Endoscopy Treatment Center,The Second Affiliated Hospital of Nanjing University of Chinese Medicine,Jiangsu Second Chinese Medicine Hospital,Nanjing,Jiangsu 210017,China)

机构地区：[1]南京中医药大学第二附属医院江苏省第二中医院消化腔镜治疗中心,江苏南京210017

出　　处：《中国临床研究》2024年第9期1428-1431,1437,共5页Chinese Journal of Clinical Research

基　　金：第四批江苏省中医临床优秀人才研修项目(苏中医科教〔2022〕1号);江苏省老年健康科研项目(LKM2022016)。

摘　　要：“诸呕吐酸,皆属于热”是《黄帝内经》中病机十九条之一,该理论揭示了呕吐吞酸等上逆症状都与“热”密切相关,治疗可从治“热”入手。本文结合中医脏腑八纲辨证理论,从病机、治法两方面分析该理论在胃食管反流病临床诊治中具有的重要指导意义,该病的主要病因为“热”,基本病机为胃气上逆,与肝胆脾肺肾肠等脏腑有关,热分虚实上下,治宜攻补和降。拟为深入分析胃食管反流病的病因病机,临证应用同病异治。为提高临床疗效提供新思路。“All acid eructation is ascribed to heat”is one of the Nineteen items of pathogenesis in the Inner Canon of Yellow Emperor(Huangdi Neijing).This theory underscores the close connection between symptoms such as vomiting and acidity with“heat”.This paper integrates differentiation of syndromes according to the eight principles and the pathological changes of the zang-fu organs of Chinese Medicine dialectical theory,in order to explore the significant implications of this principle for the clinical diagnosis and treatment of gastroesophageal reflux disease(GERD).The primary cause of GERD is identified as“heat”with the fundamental pathogenesis being the upward flow of stomach Qi,which is interconnected with other viscera including the liver,gallbladder,spleen,lung,kidney,and intestines.“Heat”can be categorized into deficiency and excess,and the treatment approach should appropriately combine strategies such as eliminating,reinforcing,harmonizing,and descending.This study aims to offer new perspectives for a thorough analysis of GERD s etiology and pathogenesis,the application of personalized treatments for similar conditions,and the enhancement of clinical efficacy.

关 键 词：胃食管反流 病机十九条 吐酸 清热降逆 

分 类 号：R221.1[医药卫生—中医基础理论] R256.31[医药卫生—中医学] R571