从“肝胃不和”论治情志胃痛

Diff erentiating and treating emotional stomach pain from the theory of the incoordination between liver and stomach

探析情志所致胃痛的发病机制,胃痛发病在胃,源于肝,主因情志失常,影响肝的疏泄功能。一是忧思恼怒致肝气郁结,气机阻滞,肝气疏泄不及,木郁克土,横逆犯胃;二是暴怒伤肝、肝郁化火,肝气疏泄太过横逆犯胃。肝气横逆犯胃致胃失和降,胃气上逆,即为“肝胃不和”。基于“肝胃不和”理论,情志所致胃病分为肝气郁结和肝郁化火所致胃痛,治疗上应予疏肝和胃止痛和泄肝和胃止痛。

When exploring the pathogenesis of emotional stomach pain,it is found that the pain occurs in the stomach yet originates from the liver,and its main cause is emotional disorders,which aff ect the liver’s conveyance and dispersion function.On the one hand,emotional disorders such as anxiety and anger will cause the depression and stagnation of liver qi and block its activities,leading to the failure of its conveyance and dispersion function and the stagnant,transverse liver qi restricting the operations of stomach qi and invading the function of the stomach.On the other hand,rages hurt the liver and the liver depression transforms into fi re,resulting in the excess of the conveyance and dispersion function in the liver and the transverse liver qi invading the stomach.Both cases cause the failure of stomach qi to descend and the adverse rising of stomach qi,known as the incoordination between the liver and stomach.Based on this theory,emotional stomach pain can be divided into two types.One is caused by the liver-qi depression and stagnation,and the other is caused by the stagnant liver-qi transforming into fire.For their treatment,the methods of dispersing stagnated liver qi for regulating stomach and relieving pain,purging stagnated liver qi for regulating stomach and relieving pain should be adopted respectively.