世界中西医结合杂志
世界中西醫結閤雜誌
세계중서의결합잡지
World Journal of Integrated Traditional and Western Medicine
2015年
8期
1155-1158
,共4页
反流性胃炎%小柴胡汤%香苏散%蒿芩清胆汤%百合乌药汤%一贯煎
反流性胃炎%小柴鬍湯%香囌散%蒿芩清膽湯%百閤烏藥湯%一貫煎
반류성위염%소시호탕%향소산%호금청담탕%백합오약탕%일관전
Reflux Gastritis%Xiaochaihu Tang%Xiangsu San%Haoqin Qingdan Tang%Baihe Wuyao Tang%Yiguan Jian
反流性胃炎是由于原发或继发因素导致十二指肠内容物反流入胃的一种病理性十二指肠胃反流（DGR），也称为胆汁反流性胃炎（BRG）。该病病程较长，具有反复发作的特点，且具有胆汁反流性胃炎-浅表胃炎-萎缩-肠化-不典型增生-胃癌的发展倾向。杨晋翔教授师从董建华院士，在胆汁反流性胃炎的中医药治疗上积累了丰富的经验，认为“胆胃不和”是导致反流性胃炎发生、发展的基本病因病机，治疗上应遵循“主在胆胃，贵在通降”之法，如胆逆犯胃、疏降失和治宜和解少阳、理气和胃，方药常选用小柴胡汤和香苏散加减；胆胃郁热、夹痰夹积治当利胆和胃、消食导滞、清热化痰，选蒿芩清胆汤化裁；久病入络、瘀血内阻治疗以活血祛瘀、益气和胃为主，方选百合乌药汤化裁；胃阴不足、胆腑失和治以滋阴益胃、利胆止痛为主，方选一贯煎加味。
反流性胃炎是由于原髮或繼髮因素導緻十二指腸內容物反流入胃的一種病理性十二指腸胃反流（DGR），也稱為膽汁反流性胃炎（BRG）。該病病程較長，具有反複髮作的特點，且具有膽汁反流性胃炎-淺錶胃炎-萎縮-腸化-不典型增生-胃癌的髮展傾嚮。楊晉翔教授師從董建華院士，在膽汁反流性胃炎的中醫藥治療上積纍瞭豐富的經驗，認為“膽胃不和”是導緻反流性胃炎髮生、髮展的基本病因病機，治療上應遵循“主在膽胃，貴在通降”之法，如膽逆犯胃、疏降失和治宜和解少暘、理氣和胃，方藥常選用小柴鬍湯和香囌散加減；膽胃鬱熱、夾痰夾積治噹利膽和胃、消食導滯、清熱化痰，選蒿芩清膽湯化裁；久病入絡、瘀血內阻治療以活血祛瘀、益氣和胃為主，方選百閤烏藥湯化裁；胃陰不足、膽腑失和治以滋陰益胃、利膽止痛為主，方選一貫煎加味。
반류성위염시유우원발혹계발인소도치십이지장내용물반류입위적일충병이성십이지장위반류（DGR），야칭위담즙반류성위염（BRG）。해병병정교장，구유반복발작적특점，차구유담즙반류성위염-천표위염-위축-장화-불전형증생-위암적발전경향。양진상교수사종동건화원사，재담즙반류성위염적중의약치료상적루료봉부적경험，인위“담위불화”시도치반류성위염발생、발전적기본병인병궤，치료상응준순“주재담위，귀재통강”지법，여담역범위、소강실화치의화해소양、리기화위，방약상선용소시호탕화향소산가감；담위욱열、협담협적치당리담화위、소식도체、청열화담，선호금청담탕화재；구병입락、어혈내조치료이활혈거어、익기화위위주，방선백합오약탕화재；위음불족、담부실화치이자음익위、리담지통위주，방선일관전가미。
Reflux gastritis is a kind of pathological duodenal gastric regurgitation(DGR),in which the duodenal content is refluxed into the stomach caused by the primary or secondary factors,also called bile reflux gastritis(BRG). This disease is characterized as long duration of sickness and repeated attacks,develo-ping in tendency as from bile reflux gastritis to superficial gastritis,to atrophy,to intestinal metaplasia,to a-typical hyperplasia and gastric cancer. Taught by the academician,Dong Jianhua,Prof. Yang Jinxiang has ac-cumulated rich experiences in the treatment of BRG with TCM. Prof. Yang believes that“disharmony of gall-bladder and stomach”is the basic etiology and pathogenesis of the occurrence and development of reflux gas-tritis. The treatment should focus on regulating the functions of gallbladder and stomach and descending qi. For example,in the case of reversed gallbladder qi attaching stomach and disharmony of ascending and de-scending,the treatment should be harmonizing Shaoyang and regulating stomach qi with modified xiaochaihu tang and xiangsu san. In the case of heat stagnation in gallbladder and stomach and interaction of phlegm and food retention,the treatment should be benefiting gallbladder qi,harmonizing stomach qi,promoting digestion, clearing heat and resolving phlegm with modified haoqin qingdan tang. In the case of chronic sickness with blood stagnation in the interior,the treatment should be activating blood circulation,removing stasis,benefi-ting qi and harmonizing stomach with modified baihe wuyao tang. In the case of stomach yin insufficiency and dysfunction of gallbladder,the treatment should be nourishing yin,benefiting stomach and gallbladder and stopping pain with modified yiguan jian.
