Discussion on traditional Chinese medicine connotation and pathogenesis of gastroesophageal reflux disease-related chest pain based on the theory of "relevance of stomach and heart"

XU Gaofan; LI Yading; HE Cong; LIU Xiaowen; WU Yue; LIU Yuyang; MENG Yangyang; WANG Yi; ZHU Shengliang; ZHOU Bingduo

doi:10.3969/j.issn.1006-2157.2023.05.017

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Discussion on traditional Chinese medicine connotation and pathogenesis of gastroesophageal reflux disease-related chest pain based on the theory of "relevance of stomach and heart"

Clinical Studies | 更新时间：2023-06-05

- Discussion on traditional Chinese medicine connotation and pathogenesis of gastroesophageal reflux disease-related chest pain based on the theory of "relevance of stomach and heart"
- Journal of Beijing University of Traditional Chinese Medicine Vol. 46, Issue 5, Pages: 705-710(2023)
- 作者机构：
  
  上海中医药大学附属岳阳中西医结合医院　上海　200437
- 作者简介：
  
  A/Prof.ZHOU Bingduo, Ph. D., Chief Physician, Master’s Supervisor. Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, 110 Ganhe Road, Hongkou District, Shanghai 200437. E-mail: bingduozhou@163.com
- 基金信息：
  
  National Natural Science Foundation of China(81973809);Traditional Chinese Medicine Innovation Team of Shanghai(2022CX002);Shanghai High level Talents Guidance Plan for Traditional Chinese Medicine(ZY〔2021—2023〕-0403);Academic Experience Research Studio Project of Shanghai Famous Traditional Chinese Medicine(SHGZS-202203)
- DOI：10.3969/j.issn.1006-2157.2023.05.017
  CLC： R259.73
- Received：16 December 2022，
  
  Published：30 May 2023
- 稿件说明：
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XU Gaofan, LI Yading, HE Cong, et al. Discussion on traditional Chinese medicine connotation and pathogenesis of gastroesophageal reflux disease-related chest pain based on the theory of "relevance of stomach and heart"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023, 46(5): 705-710.
DOI：

XU Gaofan, LI Yading, HE Cong, et al. Discussion on traditional Chinese medicine connotation and pathogenesis of gastroesophageal reflux disease-related chest pain based on the theory of "relevance of stomach and heart"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023, 46(5): 705-710. DOI： 10.3969/j.issn.1006-2157.2023.05.017.

摘要

胃食管反流病相关性胸痛是胃食管反流病食管症状中最重要的不典型症状，以“胃心相关”理论为指导探讨其中医内涵和发病机制，将胃食管反流病相关性胸痛病名为“食心痛”，其病机是胃失和降、胸络痹阻，病位在食管和胃，痛在食管和心。辨证可分肝气犯胃、痰浊痹阻、瘀血阻络、胸阳不振4种证候类型。胸阳不振证是最常见的临床分型，病机是气机升降乖戾、浊阴上逆、痰气痹阻。临证以通阳宣痹、降气化痰为主，以枳实薤白桂枝汤为基础方随证加减。现代研究认为，异常酸反流、食管－心脏反射通路、脑肠轴等重要发病机制均体现“胃心相关”理论。

Abstract

Among all atypical gastroesophageal reflux disease (GERD)-related symptoms

chest pain is the most important one. The theory of "relevance of stomach and heart" can guide the discussion on traditional Chinese medicine connotation and pathogenesis of GERD-related chest pain. We named GERD-related chest pain as "alimentary epigastralgia". Its pathological mechanism is failure of gastric qi to descend

combined with obstruction of thoracic collaterals. The disease location is the esophagus and stomach

resulting in pain in esophagus and heart. The syndrome can be divided into four types: liver qi affecting the stomach

phlegm dampness obstructing

stagnant blood obstructing the collaterals

and inactivity of thoracic yang. The commonest clinical subtype is inactivity of thoracic yang

which is caused by disordered qi activity

ascending of turbid yin

and obstruction due to phlegm and qi. In clinical practice

the main therapeutic principle is to diffuse blockage and free yang and descend qi to resolve phlegm

and the basic formula is

Zhishi Xiebai Guizhi

Decoction

with variations according to the symptoms. Modern research suggests that abnormal acid reflux

the esophagus-heart reflex pathway

the brain-gut axis

and other important pathogeneses all reflect the theory of "relevance of stomach and heart" .

关键词

Keywords

references

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