摘要
胃食管反流病(gastroesophageal reflux disease,GERD)是消化内科的常见疾病,本病当属中医学之"吐酸""食管瘅""吞酸""泛酸""噫醋"等疾病的范畴,以胃灼热、胸骨后烧灼感或疼痛、反流等为主要临床表现,其基本病机是肝胃不和、胃气上逆,以"和法"治之."和法"有广义与狭义之分,"广义和法"是指调和,顺应人体生理规律,使全身气血阴阳平衡,属治则;"狭义和法"是指 汗、和、下、消、吐、清、温、补八法之一,属治法.高教授临证灵活运用"和法",师古而不泥古,因证而施,擅长将"广义和法"思想贯穿于胃食管反流病,着眼于全身气血阴阳平衡,运用"狭义和法"调理"肝脾、肝胃、胆胃、脾胃"等兼涉脏腑之不和,创立调中降逆汤治疗GERD,临床疗效显著.
Abstract
Gastroesophageal reflux disease(GERD)is a common ailment within the realm of gastroenterology.In TCM,it falls under the category of tusuan(acid regurgitation),shiguandan(esophagus heat),tunsuan(acid swallowing),fansuan(acid regurgitation),yicu(vinegar belching)in traditional Chinese medicine.Its primary clinical manifestations include gastric burning,poststernal burning sensation,pain and reflux.The fundamental pathogenesis involves disharmony between the liver and stomach and upward regurgitation of stomach qi,requiring treatment through the harmonization method.Here,harmonization is divided into broad sense and narrow sense,where the former refers to aligning with the physiological laws of the human body to balance overall qi,blood,yin,and yang—a therapeutic principle.The latter involves specific method,which are one of the eight methods of sweating,harmonization,purgation,elimination,vomiting,clearing,warming and toning.Professor Gao Sheguang adeptly applies the harmonization method in clinical practice.Without being rigidly bound to ancient practices,he tailors interventions based on the presented syndromes.Proficient in integrating the broader concept of harmony into GERD,he focuses on balancing the qi,blood,yin,and yang throughout the body.Utilizing the narrow harmonization method,he addresses disharmonies involving the liver and spleen,liver and stomach,gallbladder and spleen,and stomach,culminating in the development of Tiaozhong Jiangni Decoction(Center-Regulating and Counterflow-Correcting Decoction)to treat GERD.This approach yields significant clinical efficacy.
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