胃脘痛源流考

胃脘痛历代病名有:胃脘痛、脘痛、胃心痛、心痛、心中痛、心腹痛、心下痛、心脾痛、胃痛、脾心痛等;唐宋以前,"胃脘痛"多与心痛相混,金元以后才逐渐将胃脘痛与心痛区分开来,并逐渐发展完善;历代医家认为其病因病机多为禀赋不足,中焦无权,饮食劳倦,损伤脾胃,情志不遂,气机失和,血络瘀滞,不通而痛,外感六淫,阻遏胃气,虫聚于内,痛引胃腑;对胃脘痛的治疗,有中药治疗:滋补脾胃法、养阴柔肝法、理气和胃法、攘外安内法、温中散寒法、温化水饮法、消食导滞法、祛痰清热法、化瘀攻下法、安蛔止痛法等,还有针灸疗法、养生食疗法。以上历代医家的认识,不仅确定中医药防治胃脘痛的理论基础,至今仍影响我们对该病的治疗理念,对临床实践起着重要启迪与昭示作用。

The Origin of Epigastric Pain

The names of epigastric pain in the past dynasties are as follows:epigastric pain,gastric cavity pain,stomach-heart pain,heart pain,heart center pain,abdominal pain,xinxia pain,heart-spleen pain,stomach pain,spleen-heart pain,etc.Before Tang and Song Dynasties," epigastric pain" was often confused with heart pain.After Jin and Yuan Dynasties,"epigastric pain" was gradually separated from heart pain,and developed and perfected.The ancient physicians think;its pathogenesis etiology is due to lack of endowment,disability of middle energizer,improper diet and overtiredness,damaged spleen and stomach,emotional damage,disharmony of qi and blood,blood stasis and stagnation of collaterals,pain because of obstruction,six exogenous factors,blocked stomach,insects gathering in the stomach,pain in the stomach,etc.In terms of treating epigastric pain,there are such following TCM therapies:method of nourishing the spleen and stomach,nourishing yin and liver,regulating qiflowing for harmonizing stomach,method of resisting foreign aggression and pacifying the interior,warming spleen and stomach for dispelling cold,warming and melting water retention,relieving dyspepsia,eliminating phlegm and clearing heat,removing blood stasis and purgative method,acupuncture and moxibustion,health cultivation and food therapy.The understanding of the above dynasties not only determines the theoretical basis of Chinese traditional medicine for treating epigastric pain,still affecting our ideas of treating this disease,but also has an important inspiration to clinical practice.