难治性胃食管反流病中医诊治策略OA

Refractory gastroesophageal reflux disease(rGERD)is a common clinical condition,with complex pathogenesis and diverse symptoms.RGERD not only presents with esophageal symptoms but may also have extraesophageal symptoms.It is not merely a digestive system disease but a multidisciplinary condition involving respiratory medicine,otolaryngology,etc.Although not directly fatal,due to its recurrent and intractable nature,rGERD seriously affects the quality of life of patients,increases their economic and mental burden,and in severe cases,may threaten their lives due to serious consequences such as concurrent upper gastrointestinal bleeding or esophageal cancer.At present,Western medicine mainly adopts symptomatic treatment.In terms of pharmacotherapy,Western medicine treatments mainly include optimizing acid-suppressive therapy regimens,combined medication,as well as anti-reflux endoscopic or surgical interventions.However,Western medicine treatments are associated with issues such as drug resistance,dependence,and adverse reactions,along with uncertainties regarding the long-term benefits of endoscopic or surgical therapies and potential complications.In contrast,traditional Chinese medicine(TCM)is characterized by the holistic concept and treatment based on syndrome differentiation.TCM compound prescriptions exhibit the characteristics of multi-target,multi-angle,and multi-mechanism actions,which can effectively improve clinical efficacy,alleviate the adverse reactions of Western medicines,and thus demonstrate relative advantages.This article elaborates on the rGERD from TCM aspects as follows:the dissection of TCM etiology and pathogenesis,the explanation of therapeutic principles and methods,the selection of prescriptions and medications,and microcosmic differentiation and treatment,etc.It also incorperates the author's clinical medication experience to provide a systematic explanation,aiming to offer certain diagnostic and therapeutic insights as well as prescriptions and medications in the treatment of rGERD.