Exploring the Approach to Diagnosis and treatment of Gastroesophageal Reflux Disease Based on the Concept of “Spleen Acting as the Defense”

目的：探讨胃食管反流病的发病机制与治疗原则，以期为胃食管反流病的诊治提供新的思路和方法。方法：通过对“脾为之卫”理论内涵的梳理，探讨脾脏功能失常对于胃食管反流病发病机制的关系，论述相应的治疗原则与处方用药。结果：“脾失之卫”为胃食管反流病发病关键，其中中虚气逆为发病之本、气郁痰阻为发病之机、湿热胶结为发病之要，根据病机分别以燮理中气、调脾复卫，理气化痰、助脾行卫，清热利湿、醒脾和卫为治疗原则。结论：应用“脾为之卫”理论有助于深化理解脾脏与胃食管反流病发病机制之间的联系，完善从脾脏论治胃食管反流病的诊治思路。Objective: To explore the pathogenesis and treatment principles of gastroesophageal reflux disease, in order to provide new ideas and methods for the diagnosis and treatment of gastroesophageal reflux disease. Methods: By combing the theoretical connotation of “spleen acting as the defense”, the relationship between spleen dysfunction and the pathogenesis of gastroesophageal reflux disease was discussed, and the corresponding treatment principles and prescription medication were discussed. Results: “Spleen losing the defense” is the key to the pathogenesis of gastroesophageal reflux disease. Among them, the deficiency of middle qi is the root of the disease, the stagnation of qi and phlegm is the pathogenesis, and the cementation of damp heat is the key to the disease. According to the pathogenesis, the treatment principles are to regulate the middle qi, regulate the spleen and restore the defense, regulate qi and resolve phlegm, help the spleen to move and defend, and clear heat and dampness, awaken the spleen and harmonize the defense. Conclusion: The application of the theory of “spleen acting as the defense” is helpful to deepen the understanding of the relationship between the spleen and the pathogenesis of gastroesophageal reflux disease, and to improve the diagnosis and treatment of gastroesophageal reflux disease from the spleen.