难治性胃食管反流病治疗的现状与思考

Current situation and thinking on treatment of refractory gastroesophageal reflux disease

分析难治性胃食管反流病难治的原因,认为部分是因为诊断问题而导致的"错治",多数则是由于治疗的方向性错误所导致的"误治"。胃食管反流病的主要矛盾不是胃酸分泌过多,而是胃酸到了不该去的地方,是酸错位。抑酸治疗只能减轻反流物中的酸度,对反流本身没有任何作用。从本质上看,除少数结构因素引起的反流外,胃食管反流病主要是一种胃肠道动力障碍性疾病,西医调整胃肠动力的手段具有一定的局限性,而中医针灸疗法则具有明显的优势,值得深入研究并加以推广。

This paper analyzes the reasons why the refractory gastroesophageal reflux disease is hard to treat. It is considered that part of them is the wrong treatment due to the wrong diagnosis,but most of them are mistreatment due to the wrong direct of treatment. The main contradiction of gastroesophageal reflux disease is not the over secretion of gastric acid ,but the wrong distribution of gastric acid ,which is called acid dislocation. The acid suppression therapy only reduces the acidity of reflux content, but shows no effect on reflux. In essence, except the minority of reflux caused by structural factor, the gastroesophageal reflux disease is a disease due to gastrointestinal dynamic disorder. The methods of western medicine in regulating the gastrointestinal motility are limited, while Chinese medical acupuncture therapy shows obvious advantages and is worth further research and promotion.