钱舒乐 王小娟 徐寅 郭璇

〔摘要〕 胃食管反流病是临床常见的多发性、难治性消化系统疾病，中医认为其多为肝脾不和，临床常见肝胃不和、肝胃郁热、脾胃虚寒、中虚气滞、胃阴不足等证型。王小娟教授根据临床观察提出肝郁水逆之证型，并以苓桂芥甘汤为主方，根据患者情况加减温阳化饮、疏肝行气之品，治疗胃食管反流病肝郁水逆证取得较好的疗效。

〔关键词〕 胃食管反流病;苓桂芥甘汤;肝郁水逆证;疏肝行气;温阳化饮;王小娟

〔中图分类号〕R256.3       〔文献标志码〕B       〔文章编号〕doi：10.3969/j.issn.1674-070X.2019.05.011

〔Abstract〕 Gastroesophageal reflux disease （GERD） is a common multiple， refractory digestive system disease in clinic， which is considered by traditional Chinese medicine （TCM） as liver and spleen disharmony. Common syndromes include liver and stomach disharmony， stagnation of liver and stomach， deficiency cold of spleen and stomach， deficiency of middle and Qi stagnation， deficiency of stomach Yin and so on. According to the clinical observation， professor WANG Xiaojuan put forward the syndrome type of liver stagnation and water regurgitation， and the main prescription was Linggui Jiegan Decoction. According to the patient's condition， she added or reduced ingredients that warm Yang for resolving fluid retention and disperse the stagnated liver for regulating Qi， and got better curative effects in the treatment of GERD with liver stagnation and water regurgitation syndrome.

〔Keywords〕 gastroesophageal reflux disease; Linggui Jiegan Decoction; liver stagnation and water regurgitation syndrome; ispersing the stagnated liver for regulating Qi; warming Yang for resolving fluid retention; WANG Xiaojuan

胃食管反流病（gastroesophageal reflux disease，GERD）為胃内容物反流至食管、口腔（包括咽喉）导致的一系列症状、终末器官效应和（或）并发症的一种疾病，主要表现为烧心、反酸、嗳气、胸骨后灼痛、咽部异物感甚至吞咽不利或者有食物溢出等症状。其内镜下可见食管黏膜糜烂、溃疡等炎症病变。也有部分患者内镜下无食管炎性改变，称为内镜下阴性的胃食管反流病或非糜烂性胃食管反流病。我国的GERD发病率虽较欧美国家低，但也日益成为一种常见的甚至是危害极大的慢性疾病[1]，可引起咽喉炎、鼻窦炎、食管狭窄甚至哮喘等多种并发症。

王小娟为湖南省名中医、一级主任医师、二级教授，从医四十余载，擅长内科疑难杂病的诊治，如在消化系统疾病、泌尿系统疾病、老年性疾病等方面形成了自己独特的辨证思路，尤其对于胃食管反流病、消化性溃疡、消化道出血、急慢性胃炎、溃疡性结肠炎、克罗恩病等疾病的治疗有深入研究与丰富的临床经验。……