胃酸反流之二

中医的认识

吴宇琛

SUM WU

Sum Wu

Registered Chinese Medicine Practitioner

Bachelor of Health Science in Traditional Chinese Medicine (UTS)

Bachelor of Science Majoring in Psychology (UOW)

Specialising in pain management and mental wellbeing through Tradition Chinese medicine in combination with modern science in mental health, dieting and nutrition.

吴宇琛，澳洲政府注册中医师、针灸师，五龙岗大学心理学学士、悉尼科技大学中医系学士，擅长用传统针灸理伤手法和中药治疗各种新旧损伤痛症，特别采用中医中药和现代心理学、营养学相结合调理治疗各种慢性病和亚健康。

胃酸反流之二

中医对胃酸反流的看法

Acid Reflux part 2 – TCM Perspective

A quick summary from our previous episode on acid reflux, it as its name implies something causes the stomach acid to rise up into your oesophagus. Leading to a common illness called heartburn which over time can cause erosion and damage to your oesophagus and oesophagitis and Barrett’s oesophagus, which are complications of acid reflux, are associated with a higher risk of cancer. About 30% of oesophageal cancer are also linked to GERD.

我们把上一集关于胃酸反流的内容快速总结一下，顾名思义胃酸反流意味着某些东西会导致胃酸上升到食道。胃灼热是一种常见疾病，随着时间的推移，可能会对食道造成侵蚀和损伤，而食道炎和巴雷特食道症（胃酸反流的并发症）与较高的癌症风险相关，大约 30% 的食道癌也与胃食管反流有关。

The cause is a weak lower oesophageal sphincter. A sphincter is a closure muscle. After you swallow, it should close to keep the food in your stomach, but it can be stuck open or open easily, allowing food to rise up into your oesophagus.

原因是食管下端括约肌无力，括约肌是闭合肌，吞咽动作后它应该关闭以将食物保留在胃中，但它可能会被卡住或打开，从而使食物上升到食道中。

Symptoms of GERD

Burning sensations in your stomach, chest, or throat
Oftentimes you may have a bad, sour, or bitter taste in your mouth
Bad breath, and a need to chew gum or suck on mints all the time
Stomach pain, which ranges from sever or burning stomach pain to the sensation of the burning rising up your throat
Lump in your throat that never seems to go away
Nausea or trouble swallowing (like you have to focus to help food go down)

胃食管反流病的症状

胃、胸部或喉咙有灼烧感
口中常常会出现难闻、酸或苦的味道
口臭，需要一直嚼口香糖或吃薄荷糖
胃痛，从严重的胃痛或烧灼感到喉咙烧灼感不等
喉咙里的肿块似乎永远不会消失
恶心或吞咽困难（例如您必须集中注意力才能帮助食物吞下）

GERD can worse with the following

Spicy food
Acidic food
Drinking a lot of caffeine (often have a plate of spaghetti and follow it up with a Coke, which is the worst thing you can do with reflux!)
Excess carbs, dairy, and sugar can also contribute significantly
Stress and anxiety

胃食管反流病 (GERD) 可能因以下情况而变得更糟

吃辛辣食物
吃酸性食物
摄入大量咖啡因（经常吃一盘义大利面，然后喝一杯可乐，这是胃食管反流最糟糕的事情！）
过量的碳水化合物、乳制品和糖也会产生显著影响
压力和焦虑

In Chinese medicine, acid reflux is due to Counterflow or rebellious Stomach Qi. Meaning your stomach energy is sending its contents upwards rather than downwards.

中医认为，胃酸反流是由于胃气逆流或逆反所致。意思是你的胃能量正在将其内容物向上而不是向下输送。

There are a few causes of Counterflow Stomach Qi.

胃气逆流的原因有以下几种。

If you eat too many high-carb foods they sit in the stomach, gather fluids, and create Dampness. This Dampness blocks the stomach and prevents it from emptying and can create fullness that forces food upward. Plus, anything that sits in the stomach can ferment and turn to Heat, which can increase acid production and send that upward too.

如果你吃太多高碳水化合物食物，它们会滞留在胃中，聚集液体并产生湿气。这种湿气会阻塞胃部并阻止其排空，并会产生饱腹感，迫使食物向上。另外，胃里的任何东西都可以发酵并转化为热量，这可以增加胃酸的产生并将其向上输送。

Another cause of Counterflow of Stomach Qi is the Liver Invading the Stomach or from the 5 elements perspective Wood invading the Earth. You may remember when we discussed in our IBS topic that the Liver can invade the Spleen. Which was one of the patterns for stress induced IBS. When you are feeling stressed or anxious the Liver Qi can stagnate or become overexcited which oppresses the Spleen Qi leading to gastrointestinal issues such as constipation and diahorrea. In this case it is still Wood invading the Earth but the targeted organ is the Stomach. The Stomach is the Earth partner Fu organ with the Spleen and if you recall, the Spleen and Stomach work together to digest, transport and transform Qi. Since the Liver is overbearing on the Stomach, it is unable to function normally. What this means is from the TCM perspective the stomach, which naturally sends food and Qi downwards instead reverses direction and goes up back and from an anatomical perspective the stress causes clenching in the abdomen and under the ribs, which can then be transferred to the stomach and causes acid and food to be pressed upward.

胃气逆流的另一个原因是肝脏侵入胃部，或从五行的角度来看是木侵入土，大家可能还记得我们在肠易激综合症专题中讨论过肝脏可以侵入脾脏，这是压力诱发肠易激综合症的模式之一。当你感到压力或焦虑时，肝气会郁滞或变得过度兴奋，从而压迫脾气，导致胃肠道问题，如便秘和腹泻。在这种情况下，入侵土的仍然是木，但目标器官是胃。胃与脾五行属土，脾与胃共同作用，消化、运化气。由于肝主宰胃，胃的功能无法正常发挥。从中医的角度来看，这意味着胃，它正常是将食物和气向下输送，而不是反转方向并向上返回，从解剖学的角度来看，压力导致腹部和肋骨下方的紧缩，然后可以转移到胃并导致酸和食物被向上挤压。

And finally the last pattern I want to mention is excess Stomach Fire. Stomach Fire is when there is excess heat in the stomach these symptoms can start off mild but gradually worsen. Someone with this pattern may first experience early signs of excess heat such as bad breath or mouth and tongue ulcers but as the heat gets worse it can develop into bleeding gums constipation and intense thirst. Over time the excess heat may disturb the normal descending of Stomach Qi causing an obstruction or Counterflow and causing symptoms such as regurgitation, vomiting and acid reflux. This pattern is common in those who eat a lot of spicy, oil or deep-fried foods as these foods are hot in nature.

最后我想提的最后一个模式是胃火过多。胃火是指胃里有过多的热气，这些症状开始时很轻微，但逐渐恶化。具有这种体质的人可能首先会出现过热的早期症状，例如口臭或口腔和舌头溃疡，但随着热气变得更严重，可能会发展为牙龈出血、便秘和口渴。随着时间的推移，过多的热气可能会扰乱胃气的正常下降，导致阻塞或逆流，并引起反流、呕吐和反酸等症状。这种模式常见于那些吃大量辛辣、油或油炸食物的人，因为这些食物性质偏热。

Acid reflux can be treated with herbal medicine using formulas such as Qing Wei San and Tiao Wei Cheng Qi Tang for Stomach heat/fire patterns. For Liver stagnation patterns Xiao Yao San is used to relieve depressive moods and gastrointestinal issues such as IBS symptoms and acid reflux. Stomach counterflow is also commonly treated with Huo Xiang Zheng Qi San.

胃酸反流可以用清胃散、调胃承气汤等中药治疗胃热/火热证。对于肝郁型，逍遥散用于缓解抑郁情绪和胃肠道问题，如肠易激综合症的症状和胃酸反流，胃逆也常用藿香正气散治疗。

最近，吴宇琛医师回国到北京参加了世界中医药联合会骨关节疾病专业委员会会议和第九届骨关节疾病学术论坛，并被选为学会理事。

以下是吴宇琛医师参加会议的照片和在欢迎会上与部分专家的合照：