浅析越鞠丸治疗慢性阻塞性肺疾病合并胃食管反流病

Preliminary Analysis of Yueju Pill(越鞠丸)in Treatment of Chronic Obstructive Pulmonary Disease Complicated with Gastroesophageal Reflux Disease

胃食管反流病(GERD)在慢性阻塞性肺疾病(COPD)患者中发病率较高,是COPD重要合并症之一,可增加COPD急性加重的风险,使得病情缠绵难愈,而GERD目前被认为是一种身心疾病,精神心理因素常可诱发GERD反流症状加剧。张琼教授经过多年临床经验,认为气郁则肝胃不和,胃气夹酸上逆犯肺,可损伤肺系,引动肺中宿痰,加重咳喘,故COPD合并GERD需肺肝胃同治。临证以越鞠丸为主方,临床疗效甚好,其一可解气郁,通畅中焦枢机缓解GERD反流症状;其二可通过解诸般六郁,尤其是"湿郁""气郁",达到消痰郁、平气喘的功效,体现了中医"异病同治"的辨证论治特点。

Gastroesophageal reflux disease(GERD)has a higher incidence in patients with chronic obstructive pulmonary disease(COPD).It is an important complications of COPD and will increase the risk of acute exacerbation of COPD,making the disease difficult to be healed.While GERD is currently considered to be a physical and mental illness,mental and psychological factors can often cause aggravation of reflux symptoms.Professor ZHANG Qiong has been engaged in clinical work for many years.In addition,she believes that Qi depression leads to liver-stomach disharmony.It can damage the lung system,induce persistent phlegm in the lung,and aggravate cough and asthma.Therefore,COPD combined with GERD needs the treatment of lung,liver and stomach.First,it can relieve Qi depression,unblock the Qi mechanism of middle-Jiao and relieve GERD reflux symptoms.Secondly,it can relieve all kinds of six depression syndromes,especially“dampness depression”and“Qi depression”,so as to achieve the effect of eliminating phlegm depression and relieving asthma,which embodies the characteristics of syndrome differentiation and treatment of“treating different diseases with same treatment methods”.