从伏邪学说角度论治胃食管反流病

胃食管反流病的发病特点及发生发展过程与伏邪致病有诸多相似之处,其病因病机多为情志不调、饮食不节、素体虚弱而致脾胃运化功能虚弱,浊阴上逆.伏邪发病的三要素可概括为正气、邪气和环境,其致病特点多不易察觉即隐匿潜藏,且在一定条件下可伺机而发,反复发作,缠绵难愈,表现为留连晚发的时间特点,深层潜藏的空间特点,并随着时间推移而发生着动态变化的特点,这与胃食管反流病多由情志不畅、饮食不节,劳役失常等诱发,停药后又极易复发的发病特点相似,而其表现除了反酸烧心等不适症状外,还同时伴随许多食管外症状如咳嗽等,易误导临床的诊断.临床治疗多从调畅内伏之肝胃气机,清化内伏之脾胃湿热,补益脾胃、顾护正气,未病先防、瘥后防复等角度着手,均有一定显著的疗效.

Discussion about treatment methods of GRED from the theory of the potential pathogenic factors

The characteristics and the development process of gastroesophageal reflux disease have many similarities with the pathogenic factors induced disease. The etiology and pathogenesis of gastroesophageal reflux disease, mostly including gloomy mood, improper diet, week constitution are caused by the weakness of spleen and stomach function, inverse of turbid yin. The pathogenetic of potential pathogenic factors has three elements, including vital qi, pathogenic qi and environment, its characteristics is imperceptible, and waiting to break out in certain conditions, repeatively attacks, difficult to cure. In other words, it's occurrence is delayed in time features and hidden deeply in space characteristics, and have dynamic changes as the time goes on. This is similar to the inducement of gastroesophageal reflux disease, which is easily relapsed after drug withdrawal. In addition to the acid reflux and heartburn, it's clinical feature also contain many extra esophageal symptoms such as cough, which may misleading the clinical diagnosis. The treatment including regulating qi activity of liver and stomach, eliminating dampness and heat of spleen and stomach, replenishing spleen and stomach, protecting of vital qi, preventing before disease onset, preventing the recrudescence of disease. The methods have a significant effect.