刘华一教授降气疏肝法治疗胃食管反流病病案举隅  

Professor LIU Huayi’s case of treating gastroesophageal reflux disease by lowering Qi and soothing liver

作　　者：李雪纯 刘华一[2] LI Xuechun;LIU Huayi

机构地区：[1]天津中医药大学,天津301617 [2]天津市中医药研究院附属医院,天津300120

出　　处：《中医临床研究》2024年第21期21-23,共3页Clinical Journal Of Chinese Medicine

摘　　要：胃食管反流病(Gastroesophageal Reflux Disease,GERD)为临床常见消化系统疾病,随着人们社会压力的增加和工作生活节奏的加快,GERD发病率呈逐年递增趋势,具有普遍性、难治性的特点。常见的西医治疗手段是抑制胃酸分泌、增强食管及胃肠动力、抗反流手术等,但往往存在一定的局限性,症状反复难愈,困扰患者日常生活,降低了生活质量。中医通过辨证论治,有效缓解因反流所致食管内外症状,并力求恢复脾胃及肝的正常生理功能,以减少疾病复发、阻止病程进展,实现标本兼治,且中医药治疗具有不良反应少等优势,值得临床推广。刘师认为中焦气机升降对于本病的发生发展至关重要,临床总结出降气疏肝以和胃为治疗大法,再根据不同证型制订具体经验用方,针对兼证加减用药,且肝胃同治、五脏同调,整体与部分相结合,重视患者治疗前情绪、不良饮食习惯等致病因素及治疗后的日常调护。本研究归纳总结GRED的中医病因病机及刘师临证对于此病之中虚气逆、肝胃不和、寒热错杂等证,分别予补中降逆、疏肝和胃、辛开苦降等法以调节中焦气机,使气机得畅、肝胃调和,疾病向愈。总结刘师临床经验用对药,并附验案一则,以冀为GERD的中医辨证论治提供理论依据,为临床治疗GERD提供诊疗新思路。Gastroesophageal reflux disease(GERD)is a common clinical digestive disease.With the increase of social pressure and the acceleration of people’s work-life rhythm,the incidence of GERD is increasing year by year,which is universal and difficult to treat.Common Western medical treatments include inhibiting gastric acid secretion,enhancing esophageal and gastrointestinal motility,and anti-reflux surgery,etc..However,these treatments often have certain limitations,and the symptoms are recurrent and difficult to be cured,thus disturbing the daily life of patients and lowering the quality of their lives.Through evidence-based treatment,Chinese medicine can effectively alleviate the internal and external symptoms of esophagus due to reflux,and seek to restore the normal physiological functions of the spleen,stomach and liver in order to reduce the recurrence of the disease and stop the progression of the disease,so as to realize both symptomatic and curative treatment,and the treatment of traditional Chinese medicine has the advantages of fewer adverse reactions,which is worth promoting in the clinic.Mentor LIU believes that the elevation of Qi(气)in the middle Jiao is crucial to the development of this disease,and clinically concludes that lowering Qi and dredging the liver and stomach is the main method of treatment,and then according to the different types of evidence to formulate specific empirical formulas for the use of medicines with the addition and subtraction of concomitant evidence,meanwhile,the liver and stomach are treated together,the five viscera are regulated together,the whole and part are combined,and the pathogenic factors such as mood and bad eating habits before treatment and the daily care after treatment are paid attention to.In this paper,the etiology and pathogenesis of GRED in Chinese medicine and Mentor LIU’s clinical experiece for the treatment of this disease are summerized.Targetting the deficiency Qi reversal,liver and stomach disharmony,cold and heat mixed and other syndromes,the tr

关 键 词：胃食管反流病 反酸 名医经验 中医治疗 

分 类 号：R573[医药卫生—消化系统]