谢晶日从“木土同病”论治胆汁反流性胃炎经验

Professor XIE Jingri's Experience in Treating Bile Reflux Gastritis from the Perspective of"Disease of both Wood and Earth"

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摘要总结谢晶日教授从“木土同病”论治胆汁反流性胃炎的临证经验。认为胆汁反流性胃炎的关键病机为肝脾失调、胆胃不和,属木土同病,主张以调和木土为治疗原则。临证将胆汁反流性胃炎分为肝郁脾虚、肝火犯胃、胆胃淤阻、胆腑湿热、胃阴亏虚五种证型,分别运用疏肝理脾汤以疏肝行气、健脾运脾,连萸清肝汤以清肝泻火、和胃止痛,通腑排石汤以通泄胆腑、和胃降逆,清胆化浊汤以清利湿热、利胆止痛,益胃汤以滋养胃阴、清泄虚火。同时针对临床证型复杂、多证兼见或病变涉及多个脏腑的情况,当肝脾同调、胆胃同治,自拟疏木调土汤作为常用经验方,随症灵活加减。 This paper summarized the clinical experience of Professor XIE Jingri in treating bile reflux gastritis from the perspective of“disease of both wood and earth”.It is believed that the pathogenesis of bile reflux gastritis is the disharmony of liver and spleen,gallbladder and stomach,which belongs to the disease of both wood and earth.The treatment principle of harmonizing wood and earth is advocated.Clinically,bile reflux gastritis is divided into five patterns including liver constraint and spleen deficiency,liver fire harassing stomach,gallbladder and stomach obstruction,damp-heat in the gallbladder,and stomach yin depletion,for which Shugan Lipi Decoction(疏肝理脾汤)can be used to soothe the liver and move qi,fortify the spleen and activate spleen,Lianyu Qinggan Decoction(连萸清肝汤)to clear the liver and drain fire,harmonize stomach and stanch bleeding,Tongfu Paishi Decoction(通腑排石汤)to unblock and discharge gallbladder,harmonize stomach and direct counterflow qi downward,Qingdan Huazhuo Decoction(清胆化浊汤)to clear and drain damp-heat,promote gallbladder function and stanch bleeding,and Yiwei Decoction(益胃汤)to enrich and nourish stomach yin,clear and discharge deficiency-fire.When the clinical pattern is complex,multiple patterns occur simultaneously,or the disease involves multiple zang fu(脏腑)organs,the liver and the spleen should be regulated simultaneously,and the gallbladder and the stomach treated together,with selfdesigned Shumu Tiaotu Decoction(疏木调土汤)recommended as a basic prescription with flexibl modification based onthesymptoms.

作者饶显俊张曦丹梁光烨曲天娇梁国英谢晶日(指导) RAO Xianjun;ZHANG Xidan;LIANG Guangye;QU Tianjiao;LIANG Guoying(Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing,100102;Heilongjiang University of Chinese Medicine;First Affiliated Hospital,Heilongjiang University of Chinese Medicine)

机构地区中国中医科学院望京医院黑龙江中医药大学黑龙江中医药大学附属第一医院

出处《中医杂志》 CSCD 北大核心 2024年第17期1757-1761,共5页 Journal of Traditional Chinese Medicine

基金国家自然科学基金(81473632) 国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教发[2016]42号) 黑龙江省博士后资助项目(LBH-Z20194)。

关键词胆汁反流性胃炎肝脾同调胆胃同治名医经验谢晶日 bile reflux gastritis regulate the liver and the spleen simultaneously treat the gallbladder and stomach simultaneously experience of famous doctors XIE Jingri

分类号 R259 [医药卫生—中西医结合] R249 [医药卫生—中医内科学]