胃脘痛的中醫診斷與治療

Diagnosis and treatment of epigastric pain in traditional Chinese medicine

10.29810/SJTTCM.202112_12(2).0006

高宗桂(Tsung-kuei Kao)；高水平(Shuiping Kao)

胃脘痛 ； 胃炎 ； 十二指腸潰瘍 ； 良導絡 ； 辨證論治 ； epigastric pain ； gastritis ； duodenal ulcer ； good collaterals ； syndrome differentiation and treatment

臺灣中醫科學雜誌

12卷2期（2021 / 12 / 26）

60 - 68

繁體中文

從內視鏡診察發現，胃脘疼痛主要是炎症，以表淺性胃炎居多，如果罹患消化性潰瘍則以十二指腸潰瘍居多。我們將胃脘痛患者以中醫辨證分型，發現胃脘痛以肝鬱氣滯型居多，其次是肝火灼胃型與其它症型。145例胃脘痛患者接受良導絡測定發現，良導絡測定總平均值以及肝經、膽經、脾經、胃經四項數值，在胃脘痛病患實驗組較正常對照組明顯偏低。以十二指腸潰瘍病患及胃炎病患的良導絡值分析，肝經—膽經，與脾經—胃經共兩組表裏經相互比較，顯示十二指腸潰瘍病患組的肝經值大於膽經值；脾經值大於胃經值；而胃炎組則是肝經值小於膽經值；而脾經值仍是大於胃經值。如將中醫辨證型及良導絡值關係合併分析，在肝鬱氣滯型，肝火灼胃型，瘀血留阻型與脾胃虛寒型，其肝經—膽經與脾經—胃經表裡經比較，顯示肝經值大於膽經值；脾經值大於胃經值。臨床治療方面，教學醫院與名老中醫治療胃脘痛，仍依照症狀分型，辨症論治為主。

According to endoscopic examination, it was found that the main cause of epigastric pain is inflammation, most of which is superficial gastritis. If suffering from peptic ulcer, duodenal ulcer is the most common. We classified the patients with epigastric pain according to TCM syndrome differentiation, and found that epigastric pain was mostly caused by syndrome of liver depression and qi stagnation, followed by the syndrome of liver fire invading stomach, and others. 145 patients with gastric pain underwent the Liangdaoluo test and found that the total average value of the Liangdaoluo determination, which included four values of the liver, gallbladder, spleen and stomach meridians, the experimental group was significantly lower than the normal control group. Based on the analysis of Liangdaoluo value in patients with duodenal ulcer and gastritis, liver-gallbladder meridians and spleen-stomach meridians were compared with each other. It showed that the liver meridian value of the duodenal ulcer patient group is greater than the gallbladder meridian value, and the spleen meridian value is greater than the stomach meridian value; while in the gastritis group, the liver meridian value is less than the gallbladder meridian value, but the spleen meridian value is still greater than the stomach meridian value. If combined and analyzed TCM syndrome differentiation and Liangdaoluo values, in the type of liver depression and qi stagnation, liver fire invading stomach type, static blood blocking collaterals type, and deficient cold of spleen and stomach type, the liver-gallbladder meridian and spleen-stomach meridian comparison show that the liver meridian value is greater than the gallbladder meridian value; the spleen meridian value is greater than the stomach meridian value. In terms of clinical treatment, teaching hospitals and well-known traditional Chinese medicine doctors still classify epigastric pain according to the type of symptoms, and treat it dialectically.

1. 鄭建民(2008)。養生運動者之良導絡生物能量整體分析。運動生理暨體能學報，7，71-82。
   連結：
2. 鄭建民(2008)。養生運動者之良導絡生物能量整體分析。運動生理暨體能學報，7，71-82。
   連結：
3. 伍建新,甘海蘋,吳紅彥,甘培尚(2017)。中醫藥辨證分型治療胃脘痛研究進展。亞太傳統醫藥，13(8)，84-85。
4. 吳皓萌,王鳳雲,張佳琪,馬祥雪,唐旭東(2021)。運用通降理論診治慢性胃炎的思路與方法。中醫雜誌，485-487+504。
5. 唐旭東,董建華(1995)。“通降論”學術思想整理。北京中醫藥大學學報，18(2)，45-48。
6. 徐瑞峰,楊建華,宋會堂(2007)。通降為主治療胃院痛淺議。現代中西醫結合雜誌，16(11)，1473-1475。
7. 張萍(2016)。胃脘痛中醫護理方案臨床應用效果評價。護理學雜誌，31(1)，50-52。
8. 劉麗影(2015)。中醫治療慢性胃炎臨床分析。中國衛生標準管理，310，225-226。

1. (2024)。淺論東方主義與中醫的「科學性」－從一場辯論談起。臺灣中醫醫學雜誌，21(1)，32-67。