仝小林教授“胃喘”论治发挥——基于胃食管反流病探讨中医“胃喘”

“Gastric Pant” Treatment Exertion of Professor TONG Xiaolin——Based on Gastreoesophageal Refluxdisease to Discuss “Gastric Pant”

喘证多见于肺心疾患,治疗方面多固化于降肺平喘、益肾纳气之属。然在临床中却有部分喘病并非肺心疾患所引起,而是由胃食管反流等胃系疾病所导致,仝小林教授将此类喘证纳入＂胃喘＂范畴。古人对＂胃喘＂的认识早见于《针经》,指出＂胃络不和,喘出于阳明之气逆＂。然＂胃喘＂之名则首见于《证治准绳》,就其病因病机及治则治法,历代医家多有论述发挥,有食积致喘、热郁致喘等学说,但在选方用药方面则无成法可寻。仝小林教授在古人认识的基础上,结合现代研究及个人临床经验,发现此类喘证多由胃食管反流病所导致,并将半夏厚朴汤作为＂靶方＂治疗此类患者数例,均收到满意的临床疗效。中医文献中亦很少将胃食管反流病与＂喘证＂相联系论述,故仝小林教授引出＂胃喘＂一词,并在参考古文献的基础上,结合胃食管反流病来探讨＂胃喘＂的病因病机,同时运用＂态靶因果＂的方略,阐述＂胃喘＂的治法治则,进而为喘证的治疗开阔思路。

Syndrome of pant is more common in heart and lung diseases,treatments like stopping pant by dropping lung-Qi and promoting inspiration by invigorating the kidney are more popular in traditional Chinese medicine（TCM）. However,there＇s another kind of pant disease that caused by not heart or lung diseases but gastreoesophageal reflux disease（GRD）and other stomach related diseases. Prof. TONG classifies this kind of pant into gastric pant,which was firstly involved in Miraculous Pivot：＂Stomach collaterals＇ discoordination gives rise to Qi-uprush,and Qi-uprush gives rise to pant＂. The name of gastric pant first appeared in Standards of Diagnosis and Treatment,lots of whose studies about etiology and pathogenesis have been left by doctors in successive dynasties,such as dyspepsia theory or stasisheat theory,but no particular TCM treatment principles left. Based on previous studies,modern researches and personal clincal experience,Prof. TONG discovered that gastric pant often caused by GRD,and was effectively treated by the target formula Banxia Houpo Decoction. Meanwhile,limited TCM literature was found to study the relationship between pant syndrome and GRD,so here we discuss the etiology and pathogenesis of gastric pant based on GRD and explore the treatment principles under the guidance of status-target-origin-result theory,thus enrich the treatment thoughts for pant disease.