从“六郁学说”角度论治难治性胃食管反流病

Discussion and Treatment on Refractory Gastroesophageal Reflux Disease Based on “Six StagnationTheory”

难治性胃食管反流病(refractory gastroesophageal reflux disease,rGERD)是指胃食管反流病对标准剂量的质子泵抑制剂(PPI)治疗应答不佳的疾病。该文介绍了食管的生理特性,并欲从朱丹溪之"六郁学说"角度论述r GERD的病因病机及其治疗,对"气、血、痰、火、湿、食"6种病理因素如何导致其"难治"做了详细阐述,为经典六郁学说理论增加了新的科学内涵和认识,并且在治疗上创造性地提出解六郁、畅气机、清火热、化痰湿、调饮食、活瘀血的综合治疗方法,为临床上深入研究rGERD及实现治疗突破提供了新的思路。

Refractory gastroesophageal reflux disease(rGERD)refers to a disease in which gastroesophageal reflux disease does not respond well to the treatment of standard-dose proton pump inhibitor(PPI).This article introduces the physiological characteristics of the esophagus,and intends to discuss the etiology,pathogenesis and treatment of rGERD from the perspective of Zhu Danxi’s"Six Stagnation Theory"and elaborate how the six pathological factors(incliuding qi,blood,phlegm,fire,dampness,and diet)lead to its"refractory",which adds new scientific connotation and understanding to the classic Six Stagnation Theory.In treating,it creatively proposes a comprehensive treatment method involving relieving six stagnation,adjusting activity of Qi,clearing heat,eliminating phlegm and dampness,adjusting diet,and activating blood stasis,which provides new ideas for in-depth clinical research on rGERD and achieving breakthroughs onits treatment.