Discussion of the significance of ascending and descending Qi movement for gastroesophageal reflux disease based on "left hepatic and right lung"
-
摘要: 胃食管反流病(gastroesophageal reflux disease,GERD)是消化科常见的难治性疾病,现代医学主要通过抑酸及促进胃动力两个方面进行治疗,但症状易反复发作,严重影响患者的生活质量。中医药在治疗GERD上有着降低复发率、减少不良反应的优势。胃气上逆是GERD的基本病机,“左肝右肺”体现了肝肺气机升降的特点,一升一降,相反相成,对维持全身气机升降协调有着重要作用。本文基于“左肝右肺”理论探讨GERD的辨治,认为升降失调、气机失畅是GERD的发病关键,临证时应当运用疏肝理肺、健脾和胃、滋补肝肺诸法,恢复肝肺气机,使得气机升降协调,胃气自降。Abstract: Gastroesophageal reflux disease(GERD) is a common refractory disease in gastroenterology. The mainstay of treatment of GERD is acid suppression and promoting gastrointestinal motility. However, the symptoms are prone to relapse. This has a serious effect on the life quality of patients. Traditional Chinese Medicine has the advantage of reducing the recurrence rate and adverse events in the treatment of GERD. In Chinese medicine, ascending stomach Qi is the basic pathogenesis of GERD. "Left hepatic and right lung" reflect the feature of ascending and descending Qi movement of hepatic and lung. It plays an important role in maintaining the coordination of the whole body Qi up and down. This article is based on the "left hepatic and right lung" theory discusses the treatment of GERD, and believes that the disorder of liver ascending and descending the lung, and the disorder of Qi movement are the key to the pathogenesis of GERD. In clinical practice, methods such as soothing the liver and regulating the lungs, invigorating the spleen and descending the stomach, and nourishing the liver and lungs should be used to restore the Qi movement. The movement of Qi ups and downs in coordination, and the stomach qi descends automatically.
-
[1] 中华医学会, 中华医学会杂志社, 中华医学会消化病学分会, 等. 胃食管反流病基层诊疗指南(2019年)[J]. 中华全科医师杂志, 2019, 18(7): 635-641. doi: 10.3760/cma.j.issn.1671-7368.2019.07.005
[2] 周金池, 赵曙光, 王新, 等. 中国部分地区基于社区人群胃食管反流病患病率Meta分析[J]. 胃肠病学和肝病学杂志, 2020, 29(9): 1012-1020. doi: 10.3969/j.issn.1006-5709.2020.09.012
[3] Katz PO, Dunbar KB, Schnoll-Sussman FH, et al. ACG clinical guideline for the diagnosis and management of gastroesophageal reflux disease[J]. Am J Gastroenterol, 2022, 117(1): 27-56. doi: 10.14309/ajg.0000000000001538
[4] 闫丽莎, 汪龙德. 中医药治疗反流性食管炎研究进展[J]. 甘肃医药, 2022, 41(3): 202-204, 216. https://www.cnki.com.cn/Article/CJFDTOTAL-GSYY202203003.htm
[5] 张庆祥. 中医基础理论[M]. 济南: 山东科学技术出版社, 2020: 67-68.
[6] 陈顺合, 杨震. 黄元御"一气周流"学说探微[J]. 现代中医药, 2020, 40(5): 5-8. https://www.cnki.com.cn/Article/CJFDTOTAL-XDZY202005003.htm
[7] 张弛, 王强. 气机升降流转与平衡[J]. 中国民间疗法, 2022, 30(12): 11-13. https://www.cnki.com.cn/Article/CJFDTOTAL-ZMJL202212004.htm
[8] 刘臻, 朱虹, 张铭倩, 等. "肝肺气机升降循环"理论治法探讨[J]. 山东中医杂志, 2018, 37(8): 631-633. https://www.cnki.com.cn/Article/CJFDTOTAL-SDZY201808002.htm
[9] 张树生. 临证指南医案译注[M]. 北京: 中国中医药出版社, 2018: 202-203.
[10] 李泽琼, 徐峰, 兰小路, 等. 基于肝肺气机失调论治血管性痴呆[J]. 世界中西医结合杂志, 2022, 17(6): 1261-1264. https://www.cnki.com.cn/Article/CJFDTOTAL-SJZX202206034.htm
[11] 高妙然, 黄盛, 闫晓玲, 等. 周剑教授从肝肺论治格雷夫斯眼病的经验[J]. 中国医药导报, 2022, 19(29): 118-121. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202229047.htm
[12] 李军祥, 谢胜, 唐旭东, 等. 消化系统常见病胃食管反流病中医诊疗指南(基层医生版)[J]. 中华中医药杂志, 2020, 35(6): 2995-2998. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202006082.htm
[13] 朱震亨. 丹溪心法[M]. 北京: 北京联合出版公司, 2018: 31-32.
[14] Cantarero-Prieto D, Moreno-Mencia P. The effects of gastrointestinal disturbances on the onset of depression and anxiety[J]. PLoS One, 2022, 17(1): e262712.
[15] 徐泉, 赵公芳, 李未华, 等. 胃食管反流病与焦虑抑郁相关性的研究进展[J]. 中国老年保健医学, 2022, 20(2): 94-97. https://www.cnki.com.cn/Article/CJFDTOTAL-LNBJ202202026.htm
[16] Riehl ME, Chen JW. The Proton Pump Inhibitor Nonresponder: a Behavioral Approach to Improvement and Wellness[J]. Curr Gastroenterol Rep, 2018, 20(7): 34.
[17] 吴根友, 注译. 道德经[M]. 长沙: 岳麓书社, 2021: 22-23.
[18] Kurin M, Shibli F, Kitayama Y, et al. Sorting out the Relationship between Gastroesophageal Reflux Disease and Sleep[J]. Curr Gastroenterol Rep, 2021, 23(9): 15.
[19] 张李梅, 孔文霞. 论胃食管反流病失眠症状的成因及相关治疗[J]. 世界最新医学信息文摘, 2019, 18(76): 263-264. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201976148.htm
[20] 郑倩, 张昊, 谭家腾, 等. 胃食管反流病与抑郁、焦虑相关性的临床研究[J]. 中国实验诊断学, 2022, 26(1): 41-44. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSZD202201014.htm
[21] 张安玲. 关于肺胃生理相关性的探讨[J]. 中医药学报, 2004, 32(3): 3-4. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXB200403001.htm
[22] 付灵玉, 吴荣焕, 张海燕, 等. 基于现代中医医案文献分析的胃食管反流病辨治特点探讨[J]. 广州中医药大学学报, 2022, 39(11): 2686-2693. https://www.cnki.com.cn/Article/CJFDTOTAL-REST202211037.htm
[23] 张欢, 李秀娟. 中医辨证治疗胃食管反流病的临床体会[J]. 系统医学, 2018, 3(1): 181-183. https://www.cnki.com.cn/Article/CJFDTOTAL-XTYX201801067.htm
[24] 宋甜甜, 张冰玉, 马月香. "聚于胃, 关于肺"的理论基础及临床应用概述[J]. 山东中医药大学学报, 2022, 46(1): 124-128. https://www.cnki.com.cn/Article/CJFDTOTAL-SDYX202201020.htm
[25] 何梦瑶. 《医碥》全本校注与研究[M]. 广州: 广东科技出版社, 2018: 16-17.
计量
- 文章访问数: 280
- PDF下载数: 128
- 施引文献: 0