裘生梁运用调畅气机法治疗胃食管反流病经验  

QIU Shengliang’s Experience on Gastro-esophageal Reflux Disease by Regulating Qi Activity

作　　者：洪千然 贺雨婷 陈双钰 李佳扬 裘生梁(指导)[2] HONG Qianran;HE Yuting;CHEN Shuangyu(The First Clinical Medical School of Zhejiang Chinese Medical University,Hangzhou(310053),China;Zhejiang Provincial Hospital of Chinese Medicine)

机构地区：[1]浙江中医药大学第一临床医学院,杭州310053 [2]浙江中医药大学附属第一医院(浙江省中医院)

出　　处：《浙江中医药大学学报》2025年第3期372-375,共4页Journal of Zhejiang Chinese Medical University

基　　金：浙江省中医药科技计划项目(2022ZA056);浙江省自然科学基金项目(LY19H270005);浙江省新苗人才计划项目(2023R410006)。

摘　　要：[目的]总结裘生梁主任中医师运用调畅气机法治疗胃食管反流病(gastro-esophageal reflux disease,GERD)的临证经验,为中医药辨治本病提供思路借鉴。[方法]通过跟师临证与医案分析,结合古籍溯源,阐述GERD“气机升降失常”的核心病机,总结裘师以调畅气机为纲,立足脾胃肝三脏,兼顾痰瘀的诊疗体系,因证施治,灵活用药,并附典型医案佐证。[结果]裘师基于调畅气机之法,通过健脾和胃、疏肝理气、化痰散瘀三法联动,灵活施治。所附典型医案较好地体现了裘师的治疗经验,且经诊调治后患者症状消除,并未复发。[结论]裘师立足气机升降理论,强调以调畅气机为核心的中医辨治GERD体系,注重脏腑气机动态平衡,提倡“药-食-情-动”多维干预,临床疗效显著,体现了中医整体观与辨证论治特色,对GERD的中医治疗具有重要参考价值。[ObjectiveObjective]To summarize the clinical experience of Dr.QIU Shengliang in treating gastro-esophageal reflux disease(GERD)through regulating Qi dynamics,providing reference for traditional Chinese medicine(TCM)syndrome differentiation and treatment of this condition.[MethodsMethods]Through clinical apprenticeships and case analysis combined with classical text research,this paper elucidates the core pathogenesis of“Qi movement disorders”in GERD.It systematically presents Dr.QIU’s diagnostic framework centering on regulating Qi dynamics,focusing on spleen-stomach-liver coordination while addressing phlegm-stasis complications.The treatment protocol features flexible herbal applications tailored to syndrome patterns,supported with a representative case study.[ResultsResults]Guided by the principle of harmonizing the flow of Qi,Dr.QIU’s approach integrates three therapeutic strategies:strengthening the spleen and stomach,soothing liver Qi,and resolving phlegm and blood stasis.The subsequent follow-up revealed that the patient’s symptoms were effectively relieved,with no recurrence,thereby validating this method.[ConclusionConclusion]Dr.QIU’s treatment system emphasizes Qi dynamics regulation as the core principle for GERD management,focusing on visceral functional balance through multi-dimensional interventions encompassing herbal therapy,dietary regulation,emotional management and exercise guidance.This holistic approach demonstrates significant clinical efficacy while embodying TCM’s characteristic holistic philosophy and syndrome differentiation principles,offering valuable insights for TCM management of GERD.

关 键 词：胃食管反流病 食管瘅 中焦气机失调 肝气郁滞 气滞血瘀 调畅气机 医案 裘生梁 

分 类 号：R256[医药卫生—中医内科学]