上海中医药大学附属岳阳中西医结合医院 上海 200437
许高凡,女,在读硕士生
# 周秉舵,男,博士,副教授,主任医师,硕士生导师,主要研究方向:中医药治疗胃食管反流病和胰腺炎的临床和基础研究,E-mail:bingduozhou@163.com
纸质出版日期:2023-05-30,
收稿日期:2022-12-16,
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许高凡, 李亚鼎, 何聪, 等. 基于“胃心相关”理论探讨胃食管反流病相关性胸痛中医内涵及发病机制[J]. 北京中医药大学学报, 2023,46(5):705-710.
XU Gaofan, LI Yading, HE Cong, et al. Discussion on traditional Chinese medicine connotation and pathogenesis of gastroesophageal reflux disease-related chest pain based on the theory of "relevance of stomach and heart"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(5):705-710.
许高凡, 李亚鼎, 何聪, 等. 基于“胃心相关”理论探讨胃食管反流病相关性胸痛中医内涵及发病机制[J]. 北京中医药大学学报, 2023,46(5):705-710. DOI: 10.3969/j.issn.1006-2157.2023.05.017.
XU Gaofan, LI Yading, HE Cong, et al. Discussion on traditional Chinese medicine connotation and pathogenesis of gastroesophageal reflux disease-related chest pain based on the theory of "relevance of stomach and heart"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(5):705-710. DOI: 10.3969/j.issn.1006-2157.2023.05.017.
胃食管反流病相关性胸痛是胃食管反流病食管症状中最重要的不典型症状,以“胃心相关”理论为指导探讨其中医内涵和发病机制,将胃食管反流病相关性胸痛病名为“食心痛”,其病机是胃失和降、胸络痹阻,病位在食管和胃,痛在食管和心。辨证可分肝气犯胃、痰浊痹阻、瘀血阻络、胸阳不振4种证候类型。胸阳不振证是最常见的临床分型,病机是气机升降乖戾、浊阴上逆、痰气痹阻。临证以通阳宣痹、降气化痰为主,以枳实薤白桂枝汤为基础方随证加减。现代研究认为,异常酸反流、食管-心脏反射通路、脑肠轴等重要发病机制均体现“胃心相关”理论。
Among all atypical gastroesophageal reflux disease (GERD)-related symptoms
chest pain is the most important one. The theory of "relevance of stomach and heart" can guide the discussion on traditional Chinese medicine connotation and pathogenesis of GERD-related chest pain. We named GERD-related chest pain as "alimentary epigastralgia". Its pathological mechanism is failure of gastric qi to descend
combined with obstruction of thoracic collaterals. The disease location is the esophagus and stomach
resulting in pain in esophagus and heart. The syndrome can be divided into four types: liver qi affecting the stomach
phlegm dampness obstructing
stagnant blood obstructing the collaterals
and inactivity of thoracic yang. The commonest clinical subtype is inactivity of thoracic yang
which is caused by disordered qi activity
ascending of turbid yin
and obstruction due to phlegm and qi. In clinical practice
the main therapeutic principle is to diffuse blockage and free yang and descend qi to resolve phlegm
and the basic formula is
Zhishi Xiebai Guizhi
Decoction
with variations according to the symptoms. Modern research suggests that abnormal acid reflux
the esophagus-heart reflex pathway
the brain-gut axis
and other important pathogeneses all reflect the theory of "relevance of stomach and heart" .
胃心相关胃食管反流病相关性胸痛中医内涵发病机制
relevance of stomach and heartgastroesophageal reflux disease-related chest paintraditional Chinese medicine connotationpathogenesis
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