基于六经开阖枢“以枢调枢”论治胃食管反流病理论探讨

Theoretical Discussion on Treating Gastroesophageal Reflux Disease Based on the Theory of “Using Pivot to Regulate Pivot” in Six Meridians Opening and Closing Pivot

胃食管反流病是胃内容物反流入食管、口腔或肺所致的不适症状和/或并发症的一种疾病。目前多采用脏腑辨证,其基本病机概括为肝胆失于疏泄、胃气上逆,与肺、肾、心三脏失调相关。六经辨证包含脏腑、经络、时空等概念,以六经辨病乃执万病之牛耳。六经病辨证关键,在于辨别六经“开阖枢”,重视脾主四维枢机、少阳阳枢、少阴阴枢对六经“开阖枢”影响。临证当以六经“开阖枢”枢机,和脾胃枢机、肝肺枢机、肺肾枢机、心肾枢机,即以枢调枢,天地和而泰,则胃食管反流病自愈。本文从六经三阴三阳“开阖枢”以枢调枢探讨胃食管反流病论治。

Gastroesophageal reflux disease is a disease of discomfort and/or complications caused by gastric contents refluxing into the esophagus,mouth or lung.At present,the syndrome differentiation of viscera is mainly used,and its basic pathogenesis is summarized as liver and gallbladder loss in catharsis and upstream gastric qi reversal,which is related to disorder among lung,kidney and heart.Syndrome differentiation of six meridians includes the concept of Zang-fu organs,meridians,space-time and so on.The key of syndrome differentiation of six meridian diseases is to distinguish the“opening and closing pivots”of the six meridians,attach importance to the spleen governing the four-dimensional pivot,Shaoyang Yang pivot and Shaoyin Yin pivot,and influence the“opening and closing pivots”of the six meridians.The clinical symptoms of gastroesophageal reflux disease can be cured by the“opening and closing pivots”of the six meridians,the spleen-stomach pivot,the liver-lung pivot,the lung-kidney pivot and the heart-kidney pivot.This article discussed the treatment of gastroesophageal reflux disease from three yin,three yang“opening and closing pivot”from six meridians based on the theory of“using pivot to regulate pivot”.