中醫藥研究論叢

211.11 胃食道逆流病辨證論治的中醫文獻探討
TJ TCM.21(1) : 123-138, 2018
胃食道逆流病辨證論治的中醫文獻探討
Discussion on TCM Syndrome Differentiation of Gastrointestinal Reflux Disease
黃勝崴1 顏家孜1 林立偉1 吳龍源1,2*
1 義守大學學士後中醫學系,高雄市,台灣
2 吳龍源中醫診所,台北市,台灣
【摘要】
目的:本文主要探討中醫觀點對於胃食道逆流病的辨證分型與治療。
方法:本研究收集中國醫學期刊網胃食道逆流病相關文獻共十五年內,將胃食道逆流病常見的症狀、病因病機、證型、用藥方法加以整理分類。
結果:從文獻研究發現胃食道逆流病中醫證候出現頻率由高到低依次為肝胃鬱熱證型、肝胃不和證型、中虛氣逆證型、氣鬱痰阻證型、瘀血阻絡證型,其中最主要的證候為肝胃鬱熱證,在胃食道逆流病中最常見。
結論:根據中國醫學期刊網相關文獻整理,可將胃食道逆流病的中醫辨證分型與治療概分為(1) 肝胃不和型:疏肝理氣、和胃降逆(柴胡疏肝散合半夏瀉心湯)、(2) 肝胃鬱熱型:疏肝泄熱、和胃降逆(柴胡疏肝散合左金丸)、(3) 痰濕內阻型:溫中化濕、和胃降逆(茯苓桂枝白朮甘草湯);清熱化濕、和胃降逆(梔子厚朴湯)、(4) 脾胃虛寒型:溫中益氣、和胃降逆(黃耆建中湯)、(5) 氣虛血瘀型:益氣養陰、化瘀散結(六君子湯合丹參、川七、鬱金)等,其對應證型藥方應用可供臨床醫師診斷處方用藥參考,有關其藥理作用機轉仍盼望於往後進一步的探討。
 
【關鍵詞】胃食道逆流、胃氣上逆、吐酸
Sheng-Wei Huang1 Chia-Tzu Yen1 Li-Wei Lin1 Lung-Yuan Wu1,2*
1The School of Chinese Medicine for Post-Baccalaureate of I-Shou University, Kaohsiung,Taiwan
2WU,LUNG-YUAN Tradition Chinese Medicine Clinic.Taipei, Taiwan
【Summary】
Aim: This study was mainly discussed the dialectical classification and prescriptions of gastroesophageal reflux disease under the view of traditional Chinese medicines.
Method: This study was collected the literatures related to gastroesophageal reflux disease in the Chinese Medical Journal Network and the fivteen-year database to analysis the symptoms, pathogenesis, dialectical type, prescriptionmethods.
Results: From the literature study found that TCM syndrome frequency of gastroesophageal reflux disease from high to low followed by liver and stomach heat syndrome type, Liver-stomach disharmony type, deficiency and qi stagnation syndrome type, phlegm obstruction due to qi stagnation type, and static blood blocking collaterals syndrome type. The liver and stomach heat syndrome type is the major type in GERD.
Conclusion: According to the relevant literatures of Chinese medical journals, the dialectical classification and treatment of gastroesophageal reflux disease can be summarized as (1) liver and stomach heat Stagnation type: dispersing stagnated liver and purging heat , regulating stomach for lowering adverse qi (Chaihu Shugan scattered left gold pills) (2) disharmony between liver and stomach type: dispersing stagnated liver for promoting qi, regulating stomach forlowering adverse qi (Chaihu Shugan San, (3) accumulation of phlegm-wetness in the body type: removing dampness for regulating stomach, and regulating stomach for lowering adverse qi (Ling-Guey-Jwu-Gan-Tang), clearing away heat and eliminating dampeness, regulating stomach for lowering adverse qi (Zhi- Zi-Hou-Pu-Tang) (4) deficient cold of spleen and stomach type: warm in the stomach for promoting qi, regulating stomach for lowering adverse qi (Huangqi built in the soup), (5) qi deficiency and blood stasis type: supplementing qi and nourishing yin, removing blood stasis and resolving static blood (Liu Junzi Tang and Danshen, Sichuan seven, turmeric). The types of diagnosis and the corresponding prescription could be the prescription reference for clinicians. The pharmacological mechanisms of the prescriptions are still looking forward to further study.
KeywordsBladder meridian, Bladder channel, Hua Tuo’s Paravertebral Points, Hua Tuo Jia Ji, Huang-Fu Mi, The Systematized Canon of Acupuncture and Moxibustion, Zhen Jiu Jia Yi Jing, Ge Hong