从胃食管反流病角度分析胃与五窍的关系
Analysis of the association between the stomach and five orifices through gastroesophageal reflux disease
唐秋双 1白兴华1
作者信息
- 1. 北京中医药大学 针灸推拿学院,北京 100029
- 折叠
摘要
目的 从胃食管反流病(gastroesophageal reflux disease,GERD)角度分析传统中医(traditional Chinere medicine,TCM)中胃与五窍(口、舌、鼻、目、耳)关联的机制和典型病案.方法 梳理现代医学有关GERD导致五窍病症的文献,以及古代文献中论述胃和五窍相关的病机和病案内容,从TCM角度分析胃食管导致五窍病症的机制.结果 现代医学认为胃在结构上与五窍相通,胃内容物经食管逆行能通过这些腔道引起五官疾患,其发生机制与TCM脾胃气机升降失调基本相符.TCM的主流观点认为五脏对应五窍,但也有胃与五窍相关的理论,脾胃气机升降失调是GERD的基本病机.TCM认为胃气浊,以降为顺,五窍为清窍,胃中浊气上干清窍是GERD导致五窍病症的主要病机;脾气清,以升为健,脾不升清,不能上荣清窍,也是反流导致五窍疾病的因素.古代医案中有一些反流导致五官病症的案例,但由于受五脏五窍理论影响,有错误辨证的情况.结论 从GERD角度分析胃与五窍的关系,不仅是对TCM五脏五窍理论的有益补充,而且进一步诠释了脾胃气机失调导致五窍病症的理念,为五窍疾病的辨证提供新思路,避免误诊误治.
Abstract
Objective To use gastroesophageal reflux disease(GERD)to interpret the pathogenesis of the association between the stomach and the five orifices(mouth,tongue,nose,eyes,and ears)in traditional Chinese medicine(TCM).Methods To ana-lyze the pathogenesis of gastroesophageal reflux-related conditions in the five orifices from the perspective of TCM,we examined modern medical literature for the disorders of the five orifices caused by gastroesophageal reflux,and ancient Chinese medical records and documents on the pathogenesis and association of GERD with the stomach and the five orifices.Results In modern medicine,the stomach is considered structurally connected to the five orifices;therefore,the regurgitation of its contents through the esophagus can cause diseases in these orifices.This pathogenesis is consistent with the abnormal flow of the spleen and stomach Qi in TCM.While TCM generally associates the five zang organs with the five orifices,it also associates the stomach with these ori-fices.Hence,an abnormal flow of the spleen and stomach Qi is the basic pathogenesis of GERD-related disorders of the five orifices.TCM considers the stomach Qi to be turbid and naturally flowing downward;the mouth,tongue,nose,eyes,and ears to be clean orifices;and an upward flow of the turbid Qi to be the primary cause of GERD-related diseases of the five orifices.Furthermore,it views the spleen Qi to be clean and naturally flowing upward,but if the clean Qi cannot flow upward or flows downward instead,the five orifices will fail to be nourished.Although ancient medical records described some cases of five orifice conditions associated with gastroesophageal reflux,practitioners might have misidentified their patterns influenced by the theory of the five zang organs corresponding to the five orifices.Conclusion An analysis of the relationship between the stomach and the five orifices through GERO will not only serve as a valuable addition to the theory of the five zang organs corresponding to the five orifices in TCM but will also provide a further interpretation of the concept of abnormal flow of the spleen and stomach Qi leading to disorders of the five orifices.Moreover,it will present novel insights for identifying disorders of the five orifices and avoiding their misdiagnosis and mis-treatment.
关键词
胃食管反流病/五窍/食管外症状/胃通五窍/清窍/浊气上逆Key words
Gastroesophageal reflux disease/Five orifices/Extraesophageal manifestations/Stomach connecting with the five ori-fices/Clean orifices/Upward flow of the turbid Qi引用本文复制引用
基金项目
&&(WFASRP202001-SC09)
出版年
2024
NETL
NSTL
万方数据