国医大师王庆国教授辨治胃下垂经验

TCM Master WANG Qingguo's Experience in Treating Gastroptosis

[目的]总结国医大师王庆国教授辨治胃下垂的临床经验。[方法]通过跟师随诊,整理并分析王教授治疗胃下垂的医案,总结王教授治疗胃下垂的辨治思路、临床心得、常用方剂及用药特色,并附验案两则加以佐证。[结果]王教授认为胃下垂属内伤杂病,气虚始终为本,病情发展由简单到复杂,一病到多病;病在脾胃,与肝胆密切相关,久病可累及肾。治疗时重视辨别病症之标本缓急,病情单纯、胃下垂为主要病症时,以恢复脏器位置为主,方用补中益气汤、枳术汤、三仙汤;病情复杂、胃下垂为次要病症时,以调理脏腑气机寒热为主,方用半夏泻心汤、柴胡桂枝汤,益气贯穿全程。所举验案一以胃下垂为主要病症,治以补脾益肾、升阳举陷;一以胃下垂为次要病症,治以平调寒热、疏肝和胃。[结论]王教授治疗胃下垂,辨别标本缓急,虚实异治,时刻顾护胃气,随证加减,精当用药,取得了良好疗效,值得学习借鉴。

[Objective] To sum up the clinical experience of Professor WANG Qingguo,a master of traditional Chinese medicine,in treating gastroptosis. [Methods] Through following up the teacher,medical records were sorted out and analyzed to summarize Professor WANG's thinking,experience and prescriptions in the treatment of gastroptosis,and two cases were attached for evidence. [Results]Professor WANG believes that gastroptosis is a kind of internal injury and miscellaneous disease. Qi deficiency is the root cause. The development of the disease is from simple to complex,from one symptom to multiple symptoms. The location is in the spleen and stomach,closely related to the liver and gallbladder,prolonged disease can affect the kidney. During treatment,attention should be paid to identifying the causes and surfacial symptoms of the disease,as well as urgent and mild symptoms. When gastroptosis is the main disease,the treatment aims to restore the location of the stomach,using Buzhong Yiqi Decoction,Zhizhu Decoction and Sanxian Decoction;when gastroptosis is a secondary disease,the treatment aims to regulate viscera and Qi,cold and heat,using Baixia Xiexin Decoction and Chaihu Guizhi Decoction. One case was that a patient with gastroptosis as the main disease who was treated to tonify the spleen and kidney and ascend Yang,the other was that a patient with gastroptosis as the secondary disease who was treated to regulate cold and heat,and soothe the liver and stomach. [Conclusion] Distinguishing the root causes from superficial symptoms,clearing the severity of symptoms,taking different approaches for asthenic and excess symptoms,caring for the Qi of stomach,and using the herbs accurately,good results are achieved in the treatment of gastroptosis by Professor WANG.