论呃逆的脏腑病机

Pathogenesis of hiccups in the viscera

我国医学认为人身是一个和谐的有机整体,在发病的过程中脏腑之间都是互相联系的。呃逆是临床常见病、多发病,其病机主要是胃气上逆动膈,但临床在治疗顽固性呃逆时以单纯的和胃降逆之法往往难以取得理想疗效。实际上,呃逆的病机往往较为复杂,不单局限于中焦脾胃。心为五脏六腑之大主,生命之主宰,若心神失主、心气逆乱必会影响脾胃升降;肺有"华盖"之称,主一身之气,职司肃降,故能与胃相助为用皆其通降,若肺气郁闭、华盖不宣则胃失通降,呃逆由生;肝主疏泄,若疏泄失司,横逆犯脾,浊气上逆动膈发为呃逆;肾者胃之关,是先天之本,若固藏失司、肾气失于摄纳则气不归元,虚气上逆动膈也可发为呃逆。遂在呃逆的诊疗过程中,不可局限于治疗中焦脾胃,因五脏六腑皆令人呃。

Chinese medicine believes that the human body is a harmonious organic whole. In the course of the disease, the viscera are interrelated. Hiccup is a common and frequently-occurring disease in clinic. Its pathogenesis is mainly gastric-Qi counteractive diaphragm. However, in the treatment of intractable hiccup, it is often difficult to achieve ideal curative effect by simple and gastric-descending methods. In fact, the pathogenesis of hiccup is often more complex, not only confined to the spleen and stomach, but also to the five internal organs and six internal organs. The dominant role of life is the loss of mind and the disorder of heart-Qi, which will affect the rise and fall of spleen and stomach. The lung is called "Huagai". The dominant body-Qi and the duty of the director surrender, so it can be used to assist the stomach. If the lung-Qi is depressed and Huagai is not declared, the stomach will collapse and hiccup will arise. Liver is the main source of dredging, if dredging and draining, transgressing the spleen, counteracting the diaphragm on turbid gas, causing hiccups;kidney is the gateway to the stomach, which is congenital. If kidney Qi is lost in absorption, Qi will not return to its original source, and counteracting diaphragm on deficiency Qi can also cause hiccups. So in the process of diagnosis and treatment of hiccup, it should not be limited to the treatment of focal point, spleen and stomach.