培土生金法治疗胃食管反流性咳嗽的理论探讨

Theoretical Discussion on Treatment of Gastroesophageal Reflux-related Cough by Reinforcing Earth to Generate Metal

[目的]探讨培土生金法治疗胃食管反流性咳嗽的理论基础。[方法]结合历代文献的相关记述,梳理培土生金法的脉络,根据胃食管反流性咳嗽的临床特点,分析培土生金法在胃食管反流性咳嗽治疗中的应用。[结果]胃食管反流性咳嗽当以脾胃亏虚为发病之本,以痰浊上犯为发病之标,肺气受损,宗气与卫气不足贯穿疾病始终。治疗当以“培土生金”之法,通过健运脾胃,杜绝生痰之源;补充宗气与卫气生成之本,恢复已伤之肺气,达到标本兼治之效。经典名方参苓白术散、麦门冬汤、黄芪建中汤等皆宗“培土生金”之旨,疗效甚佳。[结论]培土生金法治疗胃食管反流性咳嗽具有坚实的理论基础及临床意义,通过健运脾胃治疗肺脏之伤损,对治疗胃食管反流性咳嗽具有重要的指导价值。

[Objective]To explore the theoretical basis of the reinforcing earth to generate metal in the treatment of gastroesophageal reflux-related cough(GERC).[Methods]Combining the relevant accounts in the literature of the past generations,the lineage of the reinforcing earth to generate metal was sorted out;the application of such method in the treatment of GERC was analyzed according to the clinical characteristics of GERC.[Results]GERC should take deficiency of the spleen and stomach as the root cause,and phlegm turbidity as the symptoms,with the lung Qi being damaged and the deficiencies of the Zong Qi and Wei Qi throughout the disease.The treatment should be based on the method of“reinforcing earth to generate metal”,by strengthening the spleen and stomach to eliminate the sources of phlegm production,replenishing the sources of Zong Qi and Wei Qi production,and restoring the injured lung Qi to achieve the effect of treating both the symptoms and the root.The classical prescription of Shenling Baizhu Powder,Maimendong Decoction and Huangqi Jianzhong Decoction are all based on the principle of“reinforcing earth to generate metal”and are highly effective.[Conclusion]The reinforcing earth to generate metal has a solid theoretical basis and clinical significance in the treatment of GERC,and is an important guide for treating GERC by strengthening the spleen and stomach to treat injury and damage to the lung.