基于“怒则气上”理论治疗反流性食管炎的临床研究进展

Clinical Research Progress on the Treatment of Reflux Esophagitis Based on the Theory “Anger Causes the Qi to Rise”

摘要: 中医“怒则气上”理论指出，肝气郁结而化怒，进而肝失疏泄，横逆脾胃，致中焦气机升降失常，脾不升清，胃失和降，胃气夹胃酸上犯，表现为吐酸、烧心等诸症，故其发病与情志因素密切相关，核心病机为肝胃不和、胃气上逆。近年来，临床上在治疗反流性食管炎时，重视身心同治，改善患者的情绪，相关临床研究多采用疏肝健脾、理气和胃法，以达到使肝气调达的目的，并取得了较好的临床疗效，包括中药复方、针刺选穴、心理疏导等治疗方案。

Abstract: The traditional Chinese medicine theory “anger causes the qi to rise” indicates that liver qi stagnation leads to anger, which further impairs the liver’s function of free flow, causing it to invade the spleen and stomach horizontally. This results in dysfunction of the middle jiao qi mechanism, failure of the spleen to ascend clarity, and loss of stomach’s descending function. Stomach qi, carrying gastric acid, rebels upward, manifesting as acid regurgitation, heartburn, and other symptoms. Therefore, the onset of this condition is closely related to emotional factors, with the core pathogenesis being liver-stomach disharmony and stomach qi counterflow. In recent years, clinical treatment of reflux esophagitis has emphasized the simultaneous regulation of body and mind to improve patients’ emotional states. Relevant clinical studies have predominantly adopted methods such as soothing the liver and strengthening the spleen, regulating qi and harmonizing the stomach, in order to achieve the goal of promoting the free flow of liver qi, and have achieved satisfactory clinical outcomes. These treatment approaches include traditional Chinese medicine compound formulas, acupuncture point selection, and psychological counseling.