中医药治疗反流性食管炎作用机制研究进展

Research Progress on Mechanism of Traditional Chinese Medicine in Treatment of Reflux Esophagitis

反流性食管炎(reflux esophagitis,RE)若控制不佳,不仅会引起上消化道出血、食管狭窄,还会增加向Barrett食管、食管腺癌转归的风险。中医将反流性食管炎归入“吐酸、吞酸、嘈杂、呕吐、胸痞、食管瘅”等范畴,病机概括为“痰热内蕴,胃气上逆”,常以“清热化痰,降逆和胃”法论治,临床疗效颇佳,且不良反应和复发率较低。近年来关于中医药治疗反流性食管炎作用机制的研究开展得如火如荼,但尚缺乏对其研究结果的系统整理。从恢复食管括约肌功能、增强胃肠动力、抑制炎性介质分泌、改善内脏高敏感、抑制细胞增殖5个方面对中医药治疗RE作用机制的研究结果进行归纳分析,以期为中医药治疗反流性食管炎作用机制的进一步研究提供指导,同时为临床治疗和新药研发提供理论依据。

If reflux esophagitis is not well controlled,it will not only cause upper gastrointestinal bleeding and esophageal stricture,but also increase the risk of prognosis to Barrett esophagus and esophageal carcinoma.Traditional Chinese medicine classifies reflux esophagitis into the categories of“vomiting acid,swallowing acid,noise in stomach,vomiting,chest ruffian,esophagus,etc.”The pathogenesis is summarized as“phlegm-heat connotation,stomach Qi inversion”.It is often treated with the method of“clearing away heat and dissipating phlegm,reducing inversion and harmonizing stomach”.The clinical curative effect is quite good,and the adverse reactions and recurrence rates are low.In recent years,the research on the mechanism of traditional Chinese medicine in the treatment of reflux esophagitis is in full swing,but there is still a lack of systematic collation of its research results.The mechanism of traditional Chinese medicine in the treatment of reflux esophagitis was described from five aspects:restoring esophageal sphincter function,enhancing gastrointestinal motility,inhibiting the secretion of inflammatory mediators,improving visceral hypersensitivity and inhibiting cell proliferation in this paper,in order to provide the guidance for the further study of traditional Chinese medicine in the treatment of reflux esophagitis and theoretical basis for clinical treatment and new drug research and development.