胃酸反流之二

中醫的認識

吳宇琛

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.

吳宇琛，澳洲政府註冊中醫師、針灸師，五龍崗大學心理學學士、悉尼科技大學中醫系學士，擅長用傳統針灸理傷手法和中藥治療各種新舊損傷痛症，特別採用中醫中藥和現代心理學、營養學相結合調理治療各種慢性病和亞健康。

胃酸反流之二

中醫對胃酸反流的看法

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.

我們把上一集關於胃酸反流的內容快速總結一下，顧名思義胃酸反流意味著某些東西會導致胃酸上升到食道。胃灼熱是一種常見疾病，隨著時間的推移，可能會對食道造成侵蝕和損傷，而食道炎和巴雷特食道症（胃酸反流的并發症）與較高的癌症風險相關，大約 30% 的食道癌也與胃食管反流有關。

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.

原因是食管下端括約肌無力，括約肌是閉合肌，吞咽動作後它應該關閉以將食物保留在胃中，但它可能會被卡住或打開，從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)

胃食管反流病的症狀

胃、胸部或喉嚨有灼燒感
口中常常會出現難聞、酸或苦的味道
口臭，需要一直嚼口香糖或吃薄荷糖
胃痛，從嚴重的胃痛或燒灼感到喉嚨燒灼感不等
喉嚨裏的腫塊似乎永遠不會消失
惡心或吞咽困難（例如您必須集中注意力才能幫助食物吞下）

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) 可能因以下情況而變得更糟

吃辛辣食物
吃酸性食物
攝入大量咖啡因（經常吃一盤義大利面，然後喝一杯可樂，這是胃食管反流最糟糕的事情！）
過量的碳水化合物、乳製品和糖也會產生顯著影響
壓力和焦慮

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.

中醫認為，胃酸反流是由於胃氣逆流或逆反所致。意思是你的胃能量正在將其內容物向上而不是向下輸送。

There are a few causes of Counterflow Stomach Qi.

胃氣逆流的原因有以下幾種。

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，它們會滯留在胃中，聚集液體並產生濕氣。這種濕氣會阻塞胃部並阻止其排空，並會產生飽腹感，迫使食物向上。另外，胃裡的任何東西都可以發酵並轉化為熱量，這可以增加胃酸的產生並將其向上輸送。

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.

胃氣逆流的另一個原因是肝臟侵入胃部，或從五行的角度來看是木侵入土，大家可能還記得我們在腸易激綜合症專題中討論過肝臟可以侵入脾臟，這是壓力誘發腸易激綜合症的模式之一。當你感到壓力或焦慮時，肝氣會鬱滯或變得過度興奮，從而壓迫脾氣，導致胃腸道問題，如便秘和腹瀉。在這種情況下，入侵土的仍然是木，但目標器官是胃。胃與脾五行屬土，脾與胃共同作用，消化、運化氣。由於肝主宰胃，胃的功能無法正常發揮。從中醫的角度來看，這意味著胃，它正常是將食物和氣向下輸送，而不是反轉方向並向上返回，從解剖學的角度來看，壓力導致腹部和肋骨下方的緊縮，然後可以轉移到胃並導致酸和食物被向上擠壓。

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.

最後我想提的最後一個模式是胃火過多。胃火是指胃裡有過多的熱氣，這些症狀開始時很輕微，但逐漸惡化。具有這種體質的人可能首先會出現過熱的早期症狀，例如口臭或口腔和舌頭潰瘍，但隨著熱氣變得更嚴重，可能會發展為牙齦出血、便秘和口渴。隨著時間的推移，過多的熱氣可能會擾亂胃氣的正常下降，導致阻塞或逆流，並引起反流、嘔吐和反酸等症狀。這種模式常見於那些吃大量辛辣、油或油炸食物的人，因為這些食物性質偏熱。

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、調胃承氣湯等中藥治療胃熱/火熱證。對於肝鬱型，逍遙散用於緩解抑鬱情緒和胃腸道問題，如腸易激綜合症的症狀和胃酸反流，胃逆也常用藿香正氣散治療。

最近，吳宇琛醫師回國到北京參加了世界中醫藥聯合會骨關節疾病專業委員會會議和第九屆骨關節疾病學術論壇，並被選為學會理事。

以下是吳宇琛醫師參加會議的照片和在歡迎會上與部分專家的合照：