李生财治疗寒邪客胃型胃脘痛的临床经验总结

Summary of Li Shengcai’s clinical experience in the treatment of gastric epigastric pain of cold pathogen in stomach type

胃脘痛是以上腹部近心窝处疼痛为主要表现的消化内科疾病,寒邪客胃型为胃脘痛较常见的证型。多因贪凉饮冷或感受寒邪诱发,临床以胃脘部冷痛不适为主要症状,多伴有嗳气打嗝、呃逆、四肢冰冷等症状,严重时可影响患者的工作生活,属于现代医学受凉或者进食生冷食物引起的急性胃炎、急性消化性溃疡、胃痉挛等疾病的范畴。李生财主任医师临床经验丰富,善于运用中医药辨证治疗消化内科疾病,认为寒邪客胃型胃脘痛以寒邪凝滞为主,与气机异常密切相关,迁延日久易于导致寒邪化热,寒热失调,脾胃损伤。治疗本病以“寒留则气凝”为指导思想,以“温通”“理气”为主要治法,临证以厚朴、枳壳、莱菔子、陈皮、半夏、干姜等药为主,注重药对的使用,疼痛多用芍药、延胡索,反酸多用浙贝母、海螵蛸,嗳气打嗝常用旋覆花、代赭石,失眠则用酸枣仁、远志等;同时注重内外治法相结合,用中药包或热盐包外敷以开通玄府、疏通经络、温经散寒止痛,内服则温里散寒、行气消积止痛;根据临床症状辨证论治、随证加减,外敷与内服相结合,疗效显著。本研究总结李生财主任医师治疗寒邪客胃型胃脘痛的经验,并附有典型验案1则。

Gastric epigastric pain is a digestive disease mainly manifested in pain in the upper abdomen near the heart fossa.Gastric epigastric pain of cold pathogen in stomach type is a common syndrome type of epigastric pain,which is mostly induced by cold drinking or feeling cold pathogen.Clinically,cold pain and discomfort in the stomach are the main symptoms,accompanied by belching,hiccups,cold limbs,etc.which can affect the work and life of patients in severe cases.It belongs to the category of acute gastritis,acute peptic ulcer,gastric spasm and other diseases caused by feeling cold pathogen or eating raw and cold food in modern medicine.Chief physician LI Shengcai has rich clinical experience and is good at using TCM syndrome differentiation to treat gastroenteric diseases.Chief Physician LI Shengcai believes that gastric epigastric pain of cold pathogen in stomach type is mainly caused by cold evil stagnation,which is closely related to abnormal Qi(气)activity,and if it prolongs for a long time,it is easy to lead to heat disorder,disorder of cold and heat,and spleen and stomach damage.The treatment of this disease is based on“cold retention leads to Qi coagulation”as the guiding ideology,with“warming”and“regulating Qi”as the main treatment methods and clinically,Houpu(Magnolia officinalis),Zhike(Fructus aurantii),Laifuzi(Semen Raphani),Ganjiang(Zingiberis Rhizoma)and other drugs are the main medicinals and attention is given to the use of drug pairs.Peony and Rhizoma Corydalis are often used for pain.Zhejiang fritillaria and cuttlebone are often used for acid reflux.In belching and hiccuping,Inula flower and ochre are often used.Insomnia is treated with acid jujube kernel and Polygala tenuifolia.At the same time,attention is paid to the combination of internal and external treatment.Chinese medicine package or hot salt package is used as external application to open Xuanfu,dredge the meridians and collaterals,warm meridians,dispel cold and relieve pain.The internal administration is for warming the interior and dispelling cold,eliminating Qi accumulation and pain.According to the clinical symptoms of syndrome differentiation and treatment,the combination of external application and internal administration is modified,and the curative effect is remarkable.This paper summarizes the experience of chief physician LI Shengcai in the treatment of gastric epigastric pain of cold pathogen in stomach type,and one test case is attached.