| 引用本文: |
张博玲, 卢爱宵, 张丽娜, 郭洪波.从“诸逆冲上，皆属于火”理论探讨胃食管反流病病机与治疗思路[J].湖南中医药大学学报,2026,46(9):1888-1892[点击复制] |
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| 从“诸逆冲上，皆属于火”理论探讨胃食管反流病病机与治疗思路 |
| 张博玲,卢爱宵,张丽娜,郭洪波 |
| (山西中医药大学, 山西 晋中 030619;山西医科大学第一医院, 山西 太原 030001) |
| 摘要: |
| 近年来，胃食管反流病（GERD）发生率逐渐升高，目前西医以质子泵抑制剂或钾离子竞争性酸阻滞剂为主要治疗手段，但存在停药复发率高、难治性病例增多等问题。本文基于“诸逆冲上，皆属于火”理论，阐释“气火郁逆”之核心病机，根据火之来源与病性差异，将病机分为胃火内盛、气逆上冲，肝火犯胃、气火交炽，阴虚火炎、虚火上逆三型。治疗上以“发郁降逆”为核心，确立“火郁发之，逆者降之”治则，可分为清泄胃火以降逆安中、疏肝清热以燮理肝胃、滋阴润燥以复顺通降三法，使火郁得发、逆气得降，以期为临床论治GERD提供新思路。 |
| 关键词: 诸逆冲上,皆属于火|胃食管反流病|气火郁逆|发郁降逆|火郁发之|逆者降之 |
| DOI：10.3969/j.issn.1674-070X.2026.09.019 |
| 投稿时间：2026-03-27 |
| 基金项目:山西省基础研究计划项目(202403021221303)。 |
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| Pathogenesis and treatment strategies of gastroesophageal reflux disease based on the theory that “all upward counterflows are ascribed to fire” |
| ZHANG Boling, LU Aixiao, ZHANG Lina, GUO Hongbo |
| (Shanxi University of Chinese Medicine, Jinzhong, Shanxi 030619, China;The First Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China) |
| Abstract: |
| In recent years, the incidence of gastroesophageal reflux disease (GERD) has been gradually increasing. Currently, proton pump inhibitor (PPI) or potassium-competitive acid blocker (P-CAB) is the main treatment in Western medicine, but they are associated with problems including high recurrence rates after drug discontinuation and growing numbers of refractory cases. Based on the theory that "all upward counterflows are ascribed to fire", this paper elaborates on the core pathogenesis of "qi-fire stagnation and upward counterflow", which is categorized into three patterns according to differences in the source of fire and disease nature: internal exuberance of stomach fire with upward counterflow of qi, liver fire invading the stomach with qi and fire blazing together, and yin deficiency leading to fire hyperactivity with upward counterflow of deficiency heat. With "releasing stagnation and descending counterflow" as the core approach, and "releasing stagnant fire and descending upward counterflow of qi" as the therapeutic principle, the treatment can be classified into three methods: clearing stomach fire to descend counterflow of qi and harmonize the middle jiao (the spleen and stomach), soothing the liver and clearing heat to regulate the liver and stomach, and nourishing yin and moistening dryness to restore smooth downbearing. These methods enable the stagnant fire to be released and the upward counterflow of qi to be descended, with the aim of providing new insights for the clinical diagnosis and treatment of GERD. |
| Key words: all upward counterflows are ascribed to fire|gastroesophageal reflux disease|qi-fire stagnation and upward counterflow|releasing stagnation and descending qi|releasing stagnant fire|descending counterflow of qi |
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