以“土虚木贼”为核心病机论治胃食管反流病

Treating gastroesophageal reflux disease with"soil deficiency and wood invasion"as the core pathogenesis

胃食管反流病是消化系统常见疾病之一,其病机复杂,主要在于脾失健运、肝失疏泄、胃失和降导致胃气上逆,进而蕴生湿浊、郁火等病理产物加重病势,致使疾病迁延难愈。其中木土关系失衡是主要矛盾,故将其核心病机概括为“土虚木贼”,并基于此以肝脾胃为主线,分别施以健脾燥湿、清热化湿、疏木清肝、宣降肺气、滋水涵木之法,取得较好疗效,可为临床诊治提供借鉴。

Gastroesophageal reflux disease is one of the common diseases of the digestive system,and its pathogenesis is complex.The author believes that it is mainly due to the spleen dysfunction,the failure of the liver to disperse,and the failure of stomach Qi to descend,leading to the inverse rise of the stomach Qi,and then accumulates pathological products such as dampness and turbidity,depression and fire,which aggravates the disease and makes the disease difficult to heal.Among them,the imbalance of the relationship between wood and soil is the main contradiction.Therefore,its core pathogenesis is summarized as"soil deficiency and wood invasion".Based on this view,taking the liver,spleen and stomach as the main line,different treatments such as invigorating the spleen and drying dampness,clearing heat and removing dampness,soothing wood and clearing liver,promoting and depressing lung Qi,and enriching water and nourishing wood are respectively applied.The methods have achieved good curative effects,which can provide reference for clinical diagnosis and treatment,and a test case is attached as evidence.