| 史业骞.运用经方治疗脾胃病之咽-食管-胃三联征的临床经验初探[J].浙江中医药大学学报,2020,44(9):908-911. |
| 运用经方治疗脾胃病之咽-食管-胃三联征的临床经验初探 |
| The Clinical Experience of the Treatment of Spleen and Stomach Disease about Pharynx-esophagus-stomach Triad with Classic Prescriptions |
| DOI：10.16466/j.issn1005-5509.2020.09.017 |
| 中文关键词: 经方 脾胃病 咽-食管-胃三联征 反流性食管炎 胃食管反流病 梅核气 胃痞 |
| 英文关键词: classic prescriptions spleen and stomach disease pharynx-esophagus-stomach triad reflux esophagitis gastroesophageal reflux disease globus hysteriocus gastric distention |
| 基金项目:青海省中藏医药研究课题项目(2018109)；沈阳市卫生和计划生育委员会项目(沈卫计办[2018]228号) |
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| 中文摘要: |
| [目的]探讨运用经方治疗脾胃病之咽-食管-胃三联征的临床经验。[方法]根据咽-食管-胃三联征的特点，分别从咽-食管-胃三联征之“咽”“食管”“胃”的病机、症状及经方运用等方面论述中医治疗的辨证思路和治疗特色，并附以疗效明确的验案。[结果]咽-食管-胃三联征之“咽”最常见的病证是“咽炎”，可归为中医学的“梅核气”，以顺气化痰、解郁散结为法，方选半夏厚朴汤；“食管”最常见的病证是“反流性食管炎”，可归为中医学的“吞酸”“反胃”“嘈杂”等，以降逆化痰、益气和胃为法，方选旋覆代赭汤；“胃”最常见的病证是“胃食管反流病”，可归为中医学的“胸痞”，以健脾益气、顺降胃气、清肝胆热为法，方选旋覆代赭汤及半夏泻心汤。经方方小、效佳，重在抓住主要病机，切中治疗关键环节。所附验案辨证为胃虚气逆，同时伴有肝气不舒，运用经方旋覆代赭汤合半夏厚朴汤施治，治疗两周后症状基本消失。[结论]以经方治疗咽-食管-胃三联征，通过疏肝调脾、和胃降逆之法，条畅中焦气机，方证对应，能够取得较好的治疗效果，值得临床推广。 |
| 英文摘要: |
| [Objective]To explore the clinical experience of the treatment of the pharynx-esophagus-stomach triad of spleen stomach disease with classic prescriptions.[Methods]According to the characteristics of pharynx-esophagus-stomach triad， the pathogenesis， symptoms and prescriptions of “pharynx”“esophagus” and “stomach” of the pharynx-esophagus-stomach triad were discussed， and the syndrome differentiation ideas and treatment characteristics of traditional Chinese medicine in the treatment of the syndrome were discussed， by paying attention to syndrome differentiation and treatment， grasping the main pathogenesis， using the classical prescription to fundamentally treat the series of symptoms， and attached a case with clear curative effect.[Results]“Pharyngitis” is the most common disease of pharynx in the pharynx-esophagus-stomach triad， which can be classified as “globus hysteriocus” in traditional Chinese medicine. Banxia Houpu decoction can be adopted according to the method of smoothing Qi and removing phlegm， depression and resolving stagnation.“Reflux esophagitis” is the most common disease of esophagusin the pharynx-esophagus-stomach triad， which can be classified as “acid swallowing”“stomach regurgitation” and “gastric discomfort” in traditional Chinese medicine. Xuanfu Daizhe decoction can be adopted to reduce adverse reactions and resolve phlegm， tonify Qi and harmonize the stomach.“Gastroesophageal reflux disease” is the most common disease of stomach in the pharynx-esophagus-stomach triad， which can be classified as “gastric distention” in traditional Chinese medicine. Xuanfu Daizhe decoction and Banxia Xiexin decoction can be adopted to invigorate the spleen and replenish Qi， descend the stomach Qi， clear away heat of the liver and gallbladder.The classic prescriptions have few herbs but effective， emphasizing to grasp the main pathogenesis， cut into the key links of treatment.In the attached case， the patient was differentiated as deficiency of stomach and inverse of Qi， accompanied with depression of the liver Qi. After treated with Xuanfu Daizhe decoction and Banxia Houpu decoction， the symptoms disappeared after two weeks of treatment.[Conclusion]The pharynx-esophagus-stomach triad can be treated with classic prescriptions， through the method of soothing the liver and regulating the spleen， harmonizing the stomach and reducing the adverse reactions， regulating Qi circulation of middle-Jiao， the corresponding prescriptions and syndrome can achieve better therapeutic effect， which is worthy of clinical promotion. |
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