以反流性食管炎为例谈研究生《中医文献学》教学

Taking Reflux Esophagitis as Example to Discuss the Teaching of TCM Literature for Postgraduates

[目的]采用案例式教学方法,在中医文献教学中引导研究生去发现中医在疾病诊疗过程中的优势。[方法]以反流性食管炎为例,从病名源流、病因病机、临床治疗等方面,采用示例式讲解如何搜集、研读、利用中医文献,并进行中西医对比,从而总结出中医治疗的优势特色。[结果]反流性食管炎不是传统的中医病证名称,如何切入中医对此病的认识,是研究的难关;西医以胃镜为诊断依据,中医主要以患者自我症状为病名依据;西医认为胃及十二指肠内容物反流进入食管是引起食管炎症性病变的原因,中医认为反酸是本病的常见症状,胃气上逆是本病的主要病机,中西医对本病有比较一致的认识;西医以制酸为主要治疗手段,而中医从辨病和辨证结合出发,以降逆和胃为治疗大法,不以制酸为目的,更能体现胃必须保持高酸环境的实际,具有自己的优势。[结论]在病证类源流的教学实践中,采用类似反流性食管炎的案例,从病名病证、病因病机、临床治疗各个环节对应文献研究,能让研究生充分认识到文献研究的魅力,并从中感受到中医的文化自信。

[Objective]To guide postgraduates to find the advantages of the process of disease diagnosis and treatment in traditional Chinese medicine(TCM)literature teaching through case teaching method. [Methods]Taking reflux esophagitis as an example,teaching postgraduates how to collect,study and use the philology of TCM from the origin of disease name,etiology and pathogenesis,clinical treatment and other aspects and summarize its advantages and characteristics by comparing with western medicine. [Results]Reflux esophagitis is not the traditional name of TCM. How to cut into the understanding of this disease in TCM is the difficulty of research;western diagnostics bases on gastroscope,while the name of the disease in TCM is mainly based on the patient’s self-symptoms. Western medicine believes that reflux of gastric and duodenal contents in the esophagus is the cause of esophageal inflammation.TCM believes that acid reflux is a common symptom of the disease,and stomach Qi inversion is the main pathogenesis of the disease. Therefore,Chinese and western medicine have a relatively consistent understanding of this disease. The treatment of western medicine is inhibiting gastric acid production,while TCM starts from the combination of disease differentiation and syndrome differentiation,according to its own advantages,to reduce inversion and harmonize the stomach for treatment rather than inhibit gastric acid production,because the stomach must be kept in a highly acidic environment.[Conclusion]In the teaching practice of the origin of disease and syndrome,using the case of reflux esophagitis,the literature research on the disease name and syndrome,etiology and pathogenesis,clinical treatment can make postgraduates recognize the charm of philology research and feel the cultural confidence of TCM.