林平教授“谨守病机,平调脏腑”辨治反流性食管炎经验探析  

Analysis on Professor LIN Ping’s experience in differentiating and treating reflux esopha-gitis by“keeping the pathogenesis carefully and regulating the Zang-fu organs”

作　　者：王庆莲 林平 邵岩峰[1] 于莉 

机构地区：[1]福建中医药大学附属第三人民医院,福建福州350100 [2]福建中医药大学,福建福州350122

出　　处：《中医临床研究》2024年第27期53-56,共4页Clinical Journal Of Chinese Medicine

摘　　要：林平教授以“谨守病机,平调脏腑”辨治反流性食管炎(Reflux Esophagitis,RE)取得显著疗效。其认为食管为中医的“胃管”,属“腑”,而腑的生理特点为“以通为顺”“传化物而不藏”,胃及十二指肠亦皆属中医“腑”的范畴,而食管在上,胃及十二指肠在下,当胃和十二指肠中内容物逆流入食管则致病。究其根本,为脏腑功能失常及气机紊乱,而致“腑”的通降功能受阻,故以“脏腑失和,气机上逆”为核心病机。藏象学说认为人体是以五脏为中心,与六腑表里互相配合,借助经络相通,相互为用的一个整体。脏腑在生理上互通互用,病理上相互影响及传变。故诊疗中应脏腑同调,以“脏平为安,腑通为顺”为原则。整体观念为中医临床诊疗的核心指导思想,脏腑相通,如其一功能失调,必然牵涉其他脏腑。林教授遵“治未病”及“治病求本”之理,在诊疗过程中病虽未及全部脏腑,然为治病求本,防止传变,亦应在治疗相关病变脏腑的同时兼顾其他脏腑。“急则治其标,缓则治其本”,RE发病时,食管的炎症表现为标,而脏腑功能失调、气机失司为本。故在临床辨证用药过程中,症状明显时以标为主,症状缓解则重在求本,以减少复发。总而言之,在本病的辨治过程中,应“谨守病机,平调脏腑”,重视脏腑之间的关系,厘清标本主次,注意兼证,随证用药。Professor LIN Ping has achieved remarkable curative effect in the treatment of reflux esophagitis by“keeping the pathogen-Pesis carefully and regulating the Zang-fu(脏腑)organs”.Professor LIN believes that the esophagus is the“stomach tube”of tradition-al Chinese medicine and belongs to the“fu-organs”,and the physiological characteristics of the fu-organs are“to flow along”and“to transport substances without storing”,and the stomach and duodenum are also the categories of the“fu-organs”of traditional Chinese medicine,while the esophagus is on the top,the stomach and duodenum are at the bottom,and when the contents of the stomach and duodenum flow into the esophagus,the disease will be caused.Basically,the disease is due to Zang-fu function disorder and Qi(气)disorder,which leads to the core pathogenesis of“fu”being blocked and“Zang-fu disharmony and Qi reverse”.The theory of viscera state holds that the human body is a whole body centerson the five viscera,cooperating with the six fu-organs,communicating with the meridians,and serving each other.The Zang-fu or-gans interact with each other physiologically and influence each other pathologically.Therefore,in the diagnosis and treatment,the viscera should be in tune with the principle of“Harmonious Zang-organs gurantee health and smooth Fu-organs gurantee normal function.”The holistic concept is the core guiding idea of TCM clinical diagnosis and treatment.The viscera are connected,and if one of them is dysfunctional,other viscera must be involved.Following the principle of“preventive treatment of diseases”and“seeking root cause for treatment”,even though the disease does not cover all the viscera in the process of diagnosis and treatment,it should also take into account other viscera while treating the relevant lesions in order to cure the disease from the root and prevent the transmission of changes.According to“symptomatic treatment in acute condition and radical treatment in chronic case,”the symptoms of esopha

关 键 词：反流性食管炎 病机 脏 腑 

分 类 号：R571[医药卫生—消化系统]