刘杰民基于"态靶结合"理论辨治胃食管反流病的经验OA

The"state-target integration"theory,originally proposed by academician Tong Xiaolin,advocates a thera-peutic approach that classifies diseases according to their type,stage,and syndrome differentiation.This theory represents an essential pathway for the development of Traditional Chinese Medicine(TCM)within the context of modern medicine.It comprises two main components:(1)Utilizing modern scientific technologies to uncover the essence of TCM theories—such as Zang-Fu organ theory,meridian theory,as well as syndrome differentiation and treatment—to illustrate the mecha-nisms underlying TCM efficacy and provide explanations grounded in modern science;(2)Employing modern technologies to advance TCM theory itself,refine TCM treatment methods,and enhance clinical outcomes.In this framework,"state"re-fers to a macro-level summary of the core pathogenesis at a specific disease stage,categorized into excess states(e.g.,stag-nation,cold,heat,blood stasis)and deficiency states(e.g.,deficiencies of Qi,blood,Yin,or Yang)."target"denotes micro-level intervention points grounded in modern medical metrics,further classified into disease targets(underlying dis-ease pathology),symptom targets(clinical manifestations),and biomarker targets(physicochemical indicators).The"state-target integration"theory reconstructs the TCM diagnostic and therapeutic system,clarifies the strengths and limita-tions of traditional TCM thinking,enhances clinical reasoning in TCM practice,simplifies the dissemination of TCM meth-odologies,and promotes effective integration and complementarity between TCM and Western medicine—thereby improving treatment precision and clinical operability.Drawing on professor Liu Jiemin's clinical experience,this paper intends to ap-ply the"state-target integration"theory to the diagnosis and treatment of gastroesophageal reflux disease(GERD)to en-hance therapeutic efficacy.Professor Liu posits that GERD initially manifests primarily as a"deficiency state",which pro-gressively evolves into"stagnation","heat"and"blood stasis"states as the disease advances.The principle of"state regu-lation"involves strengthening the spleen and replenishing Qi,soothing the liver and clearing heat,and stop acid regurgita-tion to relieve pain.Building upon state regulation,targeted therapies are implemented by selecting corresponding target-specific formulas and herbs based on diagnostic markers,including esophagogastroduodenoscopy(EGD),24-hour esopha-geal pH monitoring,and predominant clinical symptoms to enhance clinical efficacy,reduce disease recurrence,and offer a novel approach to the clinical management of GERD.