辛开苦降法论治小儿胃食管反流病

Xinkai Kujing Method for the Treatment of Pediatric Gastroesophageal Reflux Disease

摘要: 随着社会经济的不断发展，民众饮食结构与生活习惯发生了显著变化，儿童胃食管反流病的临床发病率已经呈现出逐渐上升的趋势，该病对儿童的正常生长发育与生活质量都造成了不可忽视的影响。在长期的临床实践中，中医中药对治疗胃食管反流病有着十分独特的优势，其整体调理、标本兼治的治疗思路往往能收获稳定的治疗效果，且不良反应较少，更适合儿童这类特殊群体使用。祖国医学中并无胃食管反流病这一现代病名，结合该病的典型临床表现，中医把它归属为“吐酸”“食管瘅”“反胃”等病症的范畴。本病病机较为复杂，不同患儿受体质、诱因、病程影响，可表现为各不相同的临床证型，但病机根本始终为中焦气机升降失常，在此基础上还往往兼有阴阳失调、寒热错杂、内有郁热、湿热裹结等病理变化。辛开苦降法是顺应中焦脾胃生理特点创立的经典治法，从本病根本的病机入手，通过寒热温清药物配伍并用，起到升清降浊、斡旋中焦气机、消积化滞的作用，从而从根源上理顺脾胃功能，达到治疗儿童胃食管反流病的目的。

Abstract: With the continuous development of the social economy, significant changes have occurred in people’s dietary habits and lifestyle patterns. The clinical incidence of gastroesophageal reflux disease (GERD) among children has shown a gradual upward trend, exerting considerable impacts on their normal growth, development, and quality of life. Through long-term clinical practice, traditional Chinese medicine (TCM) has demonstrated unique advantages in treating GERD. Its holistic approach focusing on both symptomatic relief and root cause treatment often yields stable therapeutic outcomes with fewer adverse effects, making it particularly suitable for pediatric patients. Although modern medicine does not recognize GERD as a distinct disease entity in TCM, it is classified under conditions such as “acid regurgitation”, “esophageal heat stagnation”, or “gastroesophageal reflux” based on its typical clinical manifestations. The pathogenesis of this condition is complex; varying clinical presentations may arise depending on individual constitution, triggering factors, and disease duration. However, the underlying mechanism consistently involves dysfunction of qi movement in the middle energizer, often accompanied by pathological changes such as yin-yang imbalance, interplay of cold and heat, internal heat accumulation, and damp-heat retention. The “Xinkai Kujing Method” therapeutic principle, developed in accordance with the physiological characteristics of the spleen and stomach, addresses the root cause by combining cold-, heat-, warming-, and clearing herbs to promote clear qi circulation, resolve turbidity, regulate middle energizer function, and eliminate food stagnation, thereby fundamentally restoring spleen-stomach balance and achieving effective treatment of pediatric GERD.