王行宽教授"多脏调燮"辨治反流性食管炎经验探析OA

This article systematically summarizes Professor WANG Xingkuan's innovative theory and clinical practice in treating reflux esophagitis(RE)from the perspective of liver regulation.Addressing the clinical challenges of RE,such as its insidious onset,prolonged course,recurrent symptoms,and limited efficacy of Western medical treatments,Professor Wang,based on his academic philosophy of"treating miscellaneous diseases by regulating the liver and harmonizing multiple organs",has moved beyond the traditional framework that focuses solely on the spleen and stomach and emphasizes"rebellious upward flow of stomach Qi".He creatively proposes that"liver Qi invading the stomach"is the core pathogenesis of this condition.He asserts that impaired soothing and depression of Qi in the liver and gallbladder is the key to its onset.The transverse invasion of liver Qi affects the stomach,leading to the failure of stomach Qi to descend normally and the upward rebellion of Qi,resulting in symptoms such as heartburn,acid reflux,and chest and hypochondriac distension.Therefore,treatment should"prioritize the liver as the pivot,"placing the regulation and smoothening of liver-gallbladder Qi movement at the forefront.Based on this understanding of pathogenesis,Professor WANG established the distinctive therapeutic method of"harmonizing both the liver and stomach,and suppressing wood with metal"."Harmonizing both the liver and stomach"emphasizes simultaneous soothing of the liver and harmonizing of the stomach,addressing the root by dispersing liver-gallbladder depression while treating the branch by descending counterflow and harmonizing the stomach,thereby ensuring the free flow of liver Qi and the natural descent of stomach Qi.Furthermore,on the basis of jointly regulating the liver and stomach,attention is paid to the regulatory role of lung metal-"suppressing wood with metal"-utilizing the lung's governing of depuration and descent to restrain the transverse invasion of liver wood and assist the descent of stomach Qi.This forms a therapeutic pattern of synergistic regulation among the liver,stomach,and lung.This theory and therapeutic approach not only provide a clear and effective TCM diagnosis and treatment strategy for reflux esophagitis,enriching the syndrome differentiation and treatment system of spleen-stomach diseases,but also,with its core concept of"harmonizing multiple organs,"hold significant theoretical and clinical guidance value for similar digestive system diseases such as functional dyspepsia and bile reflux gastritis.It demonstrates the unique advantages of TCM's holistic approach and syndrome differentiation in treating modern complex diseases.