李廷荃教授治疗肝胃不和型胃痞经验总结

Professor LI Tingquan’s experience in treating gastric distension of the liver and stomach disharmony type

胃痞是临床常见的脾胃系疾病,以胃脘部满闷不适为主要症状表现,可累及胸膈。胃痞起病较缓,病程周期长,无压痛感。患者常常伴随缺乏食欲、消化不良等症。功能性消化不良是发生胃痞病的主要疾病之一。研究报道,胃痞发病多与胃肠运动障碍、幽门螺杆菌感染、内脏高敏感性、基因、社会心理等因素有关。近年来,胃痞病的发病率呈逐年升高趋势,而临床上常见治疗方法的疗效一般,且长期用药可引发严重的心律失常等心血管方面的不良反应。中医学从整体观念出发,认为本病多由感受外邪、内伤饮食、情志失调、体虚久病等原因导致中焦气机不利,脾胃升降失宜,采取辨证论治方法,取得良好效果。山西中医药大学附属医院李廷荃教授临证多年,擅长治疗中医内科杂病,对胃痞的治疗有独到见解。他认为肝胃不和是许多脾胃病常见的证型,临床实践表明从肝论治胃痞具有良好的临床效果。文章结合案例介绍李廷荃教授运用六君子汤联合四逆散加减治疗肝胃不和型胃痞的经验,以期为临床提供参考。

Gastric distension is a common disease of the spleen and stomach system in clinical practice.The main symptom of gastric distension is discomfort and fullness in the epigastric region,which may involve the chest and diaphragm.Gastric distension has a slow onset,a long course,and no pressure pain sensation.Patients often have anorexia,indigestion and other diseases.Functional dyspepsia is one of the main diseases associated with gastric distension.Studies have reported that the morbidity of functional dyspepsia is mainly related to gastrointestinal movement disorders,Helicobacter pylori infection,visceral hypersensitivity,gene,social psychological factors and so on.In recent years,the incidence rate of gastric distention is increasing year by year,while the efficacy of common clinical treatment methods is not good,and long-term medication can cause serious cardiovascular adverse reactions such as arrhythmia.Based on the overall concept,TCM believes that this disease is mainly caused by the attack of exogenous pathogen,internal diet injury,emotional disorder,and physical deficiency due to chronic illness,which leads to unfavorable Qi(气)movement of middle energizer,and the inappropriate elevation and fall function of the spleen and stomach.The treatment based on syndrome differentiation is used clinically,and has achieved good results.Professor LI Tingquan,from Affiliated Hospital of Shanxi University of Traditional Chinese Medicine,has been in the clinical practice for many years.He is good at treating TCM miscellaneous diseases in internal medicine,and has unique views on the treatment of gastric distension.He concludes that disharmony between liver and stomach is a common syndrome type of many spleen and stomach diseases,and that clinical practice has showed that treating gastric distension from the perspective of liver has a good clinical effect.In this article,Professor LI Tingquan’s experience in treating gastric distension of the liver and stomach disharmony type with the Liujunzi decoction(六君子汤)plus Sini San(四逆散)is introduced to provide a clinical reference.