基于“一气周流”理论探讨胃食管反流病的病机及诊治经验

Discussion on the pathogenesis,diagnosis and treatment experience of gastroesophageal reflux disease based on the theory of"circular flow of Qi"

胃食管反流病是一种常见的胃肠道疾病,虽然临床上使用质子泵抑制剂能改善患者症状,但其复发率高,甚至有部分患者对质子泵抑制剂治疗缺乏敏感性,成为了临床治疗的一个难点。笔者认为,本病的关键病机是“中焦气机升降失调”,采用平调气机、健脾助运为其主要对症治疗原则,这与清代名医黄元御在《四圣心源》中“左升右降,中气斡旋,一气周流”的核心理论体系与治疗思路相一致。基于以上对本病病因病机的认识及对“一气周流”所提出的治则治法,应用经验用方“加味和中汤”治疗胃食管反流病,效果良好。

Gastroesophageal reflux disease is a common gastrointestinal disease.Although the proton pump inhibitors can improve the symptoms of patients,its recurrence rate is high.Some patients even lack the sensitivity to proton pump inhibitor treatment which is a difficult point in clinical treatment.The author believes that the key pathogenesis of this disease is the"chaotic ascending and descending of Qi".The use of a flat air conditioner and strengthening the spleen to help transport is the main symptomatic treatment principle.The core theoretical system of"Rising from left to right,mediation of gas,and the circular flow of Qi"is consistent with the treatment idea.Based on the above understanding of the etiology and pathogenesis of the disease and the proposed rule of treatment for"the circular flow of Qi",we use the experience of applying gastroesophageal reflux disease prescription"Jiawei Hezhong Decoction"has achieved good results.