中医辨证治疗胃食管反流病的临床体会

Clinical Experience of TCM Differential Treatment of Gastroesophageal Reflux Diseases

胃食管反流病是指胃内容物反流入食管导致的一系列慢性症状和食管黏膜损伤,以及咽喉、气管等食管以外的组织损害。该病病位在食管和胃,基本病机为胃失和降,胃气上逆。造成胃气上逆的原因不外虚实两端,并归纳了4种病因病机,即湿热气滞、肝胃不和、胆胃不和、脾胃虚弱升降失常。坚持辨证和辨病相结合,采用清热化湿,理气降逆,疏肝利胆,健脾益胃等治法,选用自拟方小柴胡降逆汤等,临床灵活应用,取得了很好的疗效。

The gastroesophageal reflux disease refers to a series of chronic symptoms and esophageal mucosal injury,as well as tissue injuries of larynx and trachea caused by the gastric contents returning to the esophagus, and the basic disease mechanism is stomach-qi being unable to descend normally and adverse rising of gastric qi, and the causes of adverse rising of gastric qi are asthenia and sthenia, summarized as four kinds of causes and disease mechanisms,namely qi stagnation due to damp and hot, liver-stomach incoordination syndrome, gallbladder--stomach incoordination syndrome, and abnormal decrease and increase of deficiency of spleen and stomach. The paper insists on the combination of differentiation of syndrome and disease, uses the clearing heat and removing dampness, activating qi for lowering adverse qi, soothing-liver cholaneresis and strengthening spleen regulating stomach and selects the self-made xiaochaihu-decoction, thus obtaining a good curative effect.