胃食管反流病相关性胸痛之“食心痛”命名及辨治探微

The Naming of “Alimentary Epigastralgia” of Gastroesophageal Reflux Disease-related Chest Pain and the Associated Syndrome Differentiation and Treatment

历代研究中缺乏对胃食管反流病相关性胸痛与胸痹之间的有效区分及深入挖掘,阻碍了两者的精准定位与治疗。胃食管反流病相关性胸痛与“食心痛”高度相似,通过对两者源流、证候、病位、病因和病机内容的探析,认为胃食管反流病相关性胸痛可命名为中医学之“食心痛”。临证从痰阻、热郁、气滞病机角度出发,分别运用枳实薤白桂枝汤、栀子豉汤、橘枳姜汤等具有代表性的胸痹名方治疗胃食管反流病相关性胸痛具有较好疗效,体现了中医异病同治之理。

The distinction between gastroesophageal reflux disease(GERD)-related chest pain and chest bi(痹)has not been clearly defined in the previous studies and lacks in-depth exploration,hindering the precise positioning and treatment of the two.GERD-related chest pain is highly similar with alimentary epigastralgia",and by analyzing the origin,syndromes,disease location,etiology and pathogenesis,GERD-related chest pain can be named as"alimentary epigastralgia"in traditional Chinese medicine(TCM).In clinical practice,famous formulas for chest bi including Zhishi Xiebai Guizhi Decoction(枳实薤白桂枝汤),Zhizichi Decoction(栀子豉汤),and Juzhijiang Decoction(橘枳姜汤)are suggested to be used in correspondence to the pathogenesis of phlegm obstruction,heat constraint,and qi stagnation,of GERD-related chest pain,showing sound effect and reflecting the principle of many different diseases can be treated in the same way"in TCM.