AN Rongxian, ZHANG Qiang, WANG Yang, et al. Experience of ZHU Zhaogang Treating Esophageal Hiatal Hernia by Reinforcing Deficiency[DB/OL].(2023-09-15)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails#10.13192/j.issn.1000-1719.2022.03.006
DOI:
AN Rongxian, ZHANG Qiang, WANG Yang, et al. Experience of ZHU Zhaogang Treating Esophageal Hiatal Hernia by Reinforcing Deficiency[DB/OL].(2023-09-15)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails#10.13192/j.issn.1000-1719.2022.03.006DOI:
Experience of ZHU Zhaogang Treating Esophageal Hiatal Hernia by Reinforcing Deficiency
Esophageal hiatal hernia (EHH) is a disease that abdominal organs and tissues penetrate into thoracic cavity tem-porarily or continuously through hiatus esophageus of diaphragm. EHH lacks specific clinical manifestations and mostly belongs to the category of "acid regurgitation", "stuffiness of stomach" and "dysphagia" in traditional Chinese medicine. At present, the treatment methods in modern medicine are not only limited and few effective, but also easy to relapse, which affects the quality of life of patients for a long time. Professor ZHU Zhaogang has been engaged in clinical practice of TCM for more than fifty years and has extensive experience and unique opinions in treating spleen and stomach diseases. He believes that EHH belongs to TCM syn-drome of deficiency in origin and excess in superficiality. Spleen deficiency which makes muscle weakness is defined as basic pathogenesis while abnormal rising of stomach Qi is the superficial cause and not liver freely distributing is often a factor in the progression of the disease. Professor ZHU emphasizes the treatment should focus on the essence of the disease, which means trea-ting EHH by reinforcing deficiency, and puts forward the treatment method of strengthening spleen, supplementing Qi and strength-ening the body, with the treatment of harmonizing the stomach and descending the adverse. The Modified Buzhong Yiqi Decoction (加味补中益气汤) is the basic prescription which often be modified according to clinical symptoms and combined with diet and daily care to achieve satisfactory curative effect. This article summarized professor ZHU Zhaogang′s experience on treating EHH by reinforcing deficiency in order to provide new ideas for the clinical treatment of this disease.
关键词
食管裂孔疝从虚论治名医经验祝肇刚
Keywords
esophageal hiatal herniareinforcing deficiencyexperience of famous doctorsZHU Zhaogang
YU H, HAN C, XUE J, et al. Esophageal hiatal hernia: risk, diagnosis and management[J]. Expert review of gastroenterology &hepatology, 2018, 12(4): 319-329.
VON DIEMEN V, TRINDAD E, TRINDADE M. Hiatal hernia and gastroesophageal reflux: Study of collagen in the phrenoesophageal lig-ament[J]. Surgical endoscopy, 2016, 30(11): 5091-5098.
NATIV-ZELTZER N, RAMEAU A, KUHN M, et al. The Relation-ship Between Hiatal Hernia and Cricopharyngeus Muscle Dysfunction[J]. Dysphagia, 2019, 34(3): 391-396.
KUNIO N, DOLAN J, HUNTER J. Short esophagus[J]. The Surgical clinics of North America, 2015, 95(3): 641-652.
YANG X, HUA R, HE K, et al. Laparoscopic hernioplasty of hiatal hernia[J]. Annals of translational medicine, 2016, 4(18): 343.
MÖSSNER J. The Indications, Applications, and Risks of Proton Pump Inhibitors[J]. Deutsches Arzteblatt international, 2016, 113: 477-483.
EI-SERAH H, BECHER A, JONES R. Systematic review: persistent reflux symptoms on proton pump inhibitor therapy in primary care and community studies[J]. Alimentary pharmacology &therapeu-tics, 2010, 32(6): 720-737.
NEHRA A, ALEXANDER J, LOFTUS C, et al. Proton Pump Inhibi-tors: Review of Emerging Concerns[J]. Mayo Clinic proceedings, 2018, 93(2): 240-246.
IWAKIRI K. Treatment Strategy for Standard-Dose Proton Pump In-hibitor-Resistant Reflux Esophagitis[J]. Nippon Ika Daigaku zasshi, 2017, 84(5): 209-214.
MELMAN L, CHISHOLM P R, CURCI J A, et al. Differential regula-tion of MMP-2 in the gastrohepatic ligament of the gastroesophageal junction[J]. Surg Endosc, 2010, 24(7): 1562-1565.
BESEDOVSKY L, LANGE T, HAACK M. The Sleep-Immune Crosstalk in Health and Disease[J]. Physiological reviews, 2019, 99: 1325-1380.
YAMASAKI T, QUAN S, FASS R. The effect of sleep deficiency on esophageal acid exposure of healthy controls and patients with gas-troesophageal reflux disease[J]. Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society, 2019, 31(12): e13705.