宁状状 喻斌

【摘 要】 功能性消化不良（FD）是指一种缺乏解剖、生化、病理学改变依据的消化系统疾病，主要表现为餐后饱胀感、早饱、腹痛、腹部烧灼感等一种或多种症状。西医治疗FD多采取抑酸护胃、调节胃肠动力、保护胃粘膜等方法，但临床疗效欠佳。喻斌教授结合多年临床经验，从虚实辨证论治FD，强调“脾虚不运”为本，遵循标本兼治、健脾为主、兼以祛湿原则，运用参苓白术散加减治疗FD，临床疗效显著。

【关键词】 功能性消化不良;参苓白术散;经验

【中图分类号】R249.2/.7   【文献标志码】 A    【文章编号】1007-8517（2021）11-0085-03

Abstract：Functional dyspepsia refers to a kind of digestive tract disease， which lacks the basis of anatomical， biochemical and pathological changes. Functional dyspepsia mainly shows one or more symptoms such as postprandial fullness， early satiety， and abdominal pain， abdominal burning sensation and so on. Western medicine treatment FD mostly take the methods of inhibiting acid and protecting stomach， regulating gastrointestinal motility and protecting gastric mucosa， but the clinical effect is not good. Combined with years of clinical experience， Professor Yu Bin discussed the treatment of functional dyspepsia from the theory of syndrome differentiation of deficiency and excess， emphasized the principle of “spleen deficiency leads to poor function”， followed the principle of treating both symptoms and roots， and used Shenling Baizhu powder to treat functional dyspepsia， tonifying spleen and removing dampness. The clinical effect of the treatment is remarkable.

Keywords：Functional Dyspepsia; Shenling Baizhu Powder; Experience

功能性消化不良（Functional dyspepsia，FD）又稱消化不良，是由胃、十二指肠功能紊乱引起功能性胃病，通过检查可排除器质性或代谢性疾病，临床上常表现为餐后饱胀感、早饱、腹痛、腹部烧灼感等一种或多种症状，间或伴有上腹胀气、嗳气、恶心呕吐等症状，病程可长达数月[1]。罗马Ⅳ标准[2]将FD分为餐后不适综合征（Postprandial distress syndrome，PDS）和上腹疼痛综合征（Epigastric pain syndrome，EPS）两种类型。现代医学认为，FD的发病机制多与胃肠动力异常、胃肠激素水平变化、Hp感染、内脏高敏感性、脑-肠轴互动异常等因素相关，同时遗传、心理、社会因素也可影响FD的临床症状[3]。西医对于FD无特效药，多通过对症治疗以缓解症状，具有局限性[4]。喻斌教授认为，功能性消化不良存在多种症状重叠问题，单靶点的化学药物往往难以达到满意的疗效，主张通过中医辨证论治，对患者进行个性化施治，从而达到缓解症状、降低复发率、减轻副作用的目的。

喻斌教授系湖南中医药大学……