基于"承制自稳"探讨调枢治脘法辨治难治性胃食管反流病及Glu/GABA能神经元失衡机制OA

"Self-stabilization Function of Rehabilitation Mechanism"is the body's compliance with the operating law of biochemistry and restraint,as well as the dynamic adjustment process of balance-imbalance-rebalance and stabilizing mechanism,which can guide the reversal of hyperactivity and the prevention of disease.Psychosomatic problems and visceral hypersensitivity play an important role in refractory gastroesophageal reflux disease(rGERD)and are regulated by a key mechanism of Glu/GABAergic neuronal imbalance.Physiologically,Glu and GABAergic neurons are opposite and interact with each other,and when the birth-control and regulatory mechanisms between the two are malfunctioning,"Loss of Self-stabilization Function of Rehabilitation Mechanism"occurs,leading to neuronal micro-environmental disorders and promoting visceral hypersensitivity and the development of the disease.Based on this theory,this paper discusses the intrinsic connection between the imbalance of Glu/GABAergic neurons and the core mechanism of rGERD,which is"disorder of the pivot,dysregulation of qi,and stagnation and deficiency against the gastroesophageal",and proposes that the essence of treating rGERD is to harmonize the balance relationship of pivot,with emphasis on regulating the pivot and qi.The treatment principle of"regulating the pivot and treating the epigastric region"is to adjust the pivot of the liver and stomach in order to lower the turbidity and rebelliousness,adjust the pivot of mind in order to resolve the depression,and benefit the yang and nourish the yin in order to help the smoothing and moisturizing as the treatment method,so as to make the body return to the state of"Self-stabilization".We also summarize the relevant studies of TCM intervening in the imbalance of Glu/GABAergic neurons and restoring the E/I balance,which will provide new ideas for the clinical research and mechanism exploration of the combination of TCM and Western medicine in the prevention and treatment of rGERD.