Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2024, Vol. 38 ›› Issue (3): 102-108.doi: 10.6040/j.issn.1673-3770.0.2023.056

• Academic Discussion • Previous Articles    

Analysis of the association between the stomach and five orifices through gastroesophageal reflux disease

TANG Qiushuang, BAI Xinghua   

  1. School of Acu-Moxibustion and Tuina, Beijing University of Chinese Medicine, Beijing 100029, China
  • Published:2024-06-04

PDF (PC)

24

Abstract: Objective To use gastroesophageal reflux disease(GERD)to interpret the pathogenesis of the association between the stomach and the five orifices(mouth, tongue, nose, eyes, and ears)in traditional Chinese medicine(TCM). Methods To analyze the pathogenesis of gastroesophageal reflux-related conditions in the five orifices from the perspective of TCM, we examined modern medical literature for the disorders of the five orifices caused by gastroesophageal reflux, and ancient Chinese medical records and documents on the pathogenesis and association of GERD with the stomach and the five orifices. Results In modern medicine, the stomach is considered structurally connected to the five orifices; therefore, the regurgitation of its contents through the esophagus can cause diseases in these orifices. This pathogenesis is consistent with the abnormal flow of the spleen and stomach Qi in TCM. While TCM generally associates the five zang organs with the five orifices, it also associates the stomach with these orifices. Hence, an abnormal flow of the spleen and stomach Qi is the basic pathogenesis of GERD-related disorders of the five orifices. TCM considers the stomach Qi to be turbid and naturally flowing downward; the mouth, tongue, nose, eyes, and ears to be clean orifices; and an upward flow of the turbid Qi to be the primary cause of GERD-related diseases of the five orifices. Furthermore, it views the spleen Qi to be clean and naturally flowing upward, but if the clean Qi cannot flow upward or flows downward instead, the five orifices will fail to be nourished. Although ancient medical records described some cases of five orifice conditions associated with gastroesophageal reflux, practitioners might have misidentified their patterns influenced by the theory of the five zang organs corresponding to the five orifices. Conclusion An analysis of the relationship between the stomach and the five orifices through GERO will not only serve as a valuable addition to the theory of the five zang organs corresponding to the five orifices in TCM but will also provide a further interpretation of the concept of abnormal flow of the spleen and stomach Qi leading to disorders of the five orifices. Moreover, it will present novel insights for identifying disorders of the five orifices and avoiding their misdiagnosis and mistreatment.

Key words: Gastroesophageal reflux disease, Five orifices, Extraesophageal manifestations, Stomach connecting with the five orifices, Clean orifices, Upward flow of the turbid Qi

CLC Number: 

  • R766
[1] 中华中医药学会脾胃病分会. 胃食管反流病中医诊疗专家共识意见(2017)[J]. 中国中西医结合消化杂志, 2017, 25(5): 321-326. doi:10.3969/j.issn.1671-038X.2017.05.01
[2] 中国医疗保健国际交流促进会胃食管反流病学分会. 中国胃食管反流病多学科诊疗共识2022(一)[J]. 中华胃食管反流病电子杂志, 2022, 9(2): 51-86. doi:10.3877/cma.j.issn.2095-8765.2022.02.001
[3] 黄晓文, 潘炜炳, 范乾, 等. 常熟地区253例胃食管反流病患者临床特点及疗效分析[J]. 光明中医, 2022, 37(14): 2467-2472. doi: 10.3969/j.issn.1003-8914.2022.14.001 HUANG Xiaowen, PAN Weibing, FAN Qian, et al. Analysis on the clinical characteristics and curative effect of 253 patients with gastroesophageal reflux disease in Changshu area[J]. Guangming Journal of Chinese Medicine, 2022, 37(14): 2467-2472. doi: 10.3969/j.issn.1003-8914.2022.14.001
[4] Lechien JR. Do otolaryngologists over- or underestimate laryngopharyngeal reflux symptoms and findings in clinical practice A comparison study between the true prevalence and the otolaryngologist-estimated prevalence of symptoms and findings[J]. J Clin Med, 2022, 11(17): 5192. doi:10.3390/jcm11175192
[5] 白兴华. 胃食管反流病: 一种很容易被误辨的疾病[J]. 上海中医药杂志, 2019, 53(5): 14-19. doi:10.16305/j.1007-1334.2019.05.004 BAI Xinghua. Gastroesophageal reflux disease: an easily misidentified disorder[J]. Shanghai Journal of Traditional Chinese Medicine, 2019, 53(5): 14-19. doi:10.16305/j.1007-1334.2019.05.004
[6] Akinola MA, Oyedele TA, Akande KO, et al. Gastroesophageal reflux disease: prevalence and Extraesophageal manifestations among undergraduate students in South West Nigeria[J]. BMC Gastroenterol, 2020, 20(1): 160. doi:10.1186/s12876-020-01292-1
[7] Picos A, Lasserre JF, Chisnoiu AM, et al. Factors associated with dental erosions in gastroesophageal reflux disease: a cross-sectional study in patients with heartburn[J]. Med Pharm Rep, 2020, 93(1): 23-29. doi:10.15386/mpr-1332
[8] Shimazu R, Yamamoto M, Minesaki A, et al. Dental and oropharyngeal lesions in rats with chronic acid reflux esophagitis[J]. Auris Nasus Larynx, 2018, 45(3): 522-526. doi:10.1016/j.anl.2017.08.011
[9] Silva MA, Damante JH, Stipp AC, et al. Gastroesophageal reflux disease: new oral findings[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2001, 91(3): 301-310. doi:10.1067/moe.2001.111139
[10] 王磊,李保卫,王刚,等. 阻塞性睡眠呼吸暂停低通气综合征患者夜间碱反流初步研究[J]. 山东大学耳鼻喉眼学报, 2023, 37(6): 75-79. doi: 10.6040/j.issn.1673-3770.0.2022.138 WANG Lei, LI Baowei, WANG Gang, et al. A preliminary study on nocturnal alkali reflux in OSAHS patients[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2023, 37(6): 75-79. doi: 10.6040/j.issn.1673-3770.0.2022.138
[11] Florou V, Karkos PD, Marini K, et al. Laryngopharyngeal reflux and olfaction disorders. is there any connection A scoping review[J]. Maedica(Bucur), 2022, 17(2): 471-480. doi:10.26574/maedica.2022.17.2.471
[12] Ozmen S, Yücel OT, Sinici I, et al. Nasal pepsin assay and pH monitoring in chronic rhinosinusitis[J]. Laryngoscope, 2008, 118(5): 890-894. doi:10.1097/MLG.0b013e318165e324
[13] Phipps CD, Wood WE, Gibson WS, et al. Gastroesophageal reflux contributing to chronic sinus disease in children: a prospective analysis[J]. Arch Otolaryngol Head Neck Surg, 2000, 126(7): 831-836. doi:10.1001/archotol.126.7.831
[14] Kowalik K, Krzeski A. The role of pepsin in the laryngopharyngeal reflux[J]. Pol Otolaryngol, 2017, 71(6): 7-13. doi:10.5604/01.3001.0010.7194
[15] Sella GCP, Tamashiro E, Anselmo-Lima WT, et al. Relation between chronic rhinosinusitis and gastroesophageal reflux in adults: systematic review[J]. Braz J Otorhinolaryngol, 2017, 83(3): 356-363. doi:10.1016/j.bjorl.2016.05.012
[16] Brunworth JD, Mahboubi H, Garg R, et al. Nasopharyngeal acid reflux and Eustachian tube dysfunction in adults[J]. Ann Otol Rhinol Laryngol, 2014, 123(6): 415-419. doi:10.1177/0003489414526689
[17] 徐冰, 王采集, 陈敏, 等. 单侧SOM患者中耳积液中胰蛋白酶和胃蛋白酶检测结果分析[J]. 听力学及言语疾病杂志, 2022, 30(4): 363-365. doi: 10.3969/j.issn.1006-7299.2022.04.005 XU Bing, WANG Caiji, CHEN Min, et al. Analysis of detection results of trypsin and pepsin in middle ear effusion of unilateral SOM patients[J]. Journal of Audiology and Speech Pathology, 2022, 30(4): 363-365. doi: 10.3969/j.issn.1006-7299.2022.04.005
[18] Buyruk A, Osma Ü, Y lmaz MD, et al. Pepsinogen identification in the middle ear fluid of children with otitis media with effusion[J]. J Ear Nose Throat, 2016, 26(2): 73-78. doi:10.5606/kbbihtisas.2016.83669
[19] Al-Saab F, Manoukian JJ, Al-Sabah B, et al. Linking laryngopharyngeal reflux to otitis media with effusion: pepsinogen study of adenoid tissue and middle ear fluid[J]. Le J D'oto Rhino Laryngol De Chir Cervico Faciale, 2008, 37(4): 565-571
[20] Magliulo G, Plateroti R, Plateroti AM. Gastroesophageal reflux disease and the presence of pepsin in the tears[J]. Med Hypotheses, 2013, 80(2): 129-130. doi:10.1016/j.mehy.2012.11.008
[21] Iannella G, di Nardo G, Plateroti R, et al. Investigation of pepsin in tears of children with laryngopharyngeal reflux disease[J]. Int J Pediatr Otorhinolaryngol, 2015, 79(12): 2312-2315. doi:10.1016/j.ijporl.2015.10.034
[22] Plateroti R, Sacchetti M, Magliulo G, et al. Evidence of pepsin-related ocular surface damage and dry eye(PROD syndrome)in patients with laryngopharyngeal reflux[J]. Life(Basel), 2020, 10(9): E202. doi:10.3390/life10090202
[23] Budylina SM, Dmitrieva LA, Kostina NV, et al. Taste perception during clinical symptom complex of gastroesophageal reflux disease[J]. Patol Fiziol Eksp Ter, 2015, 59(2): 51-56
[24] Kabadi A, Saadi M, Schey R, et al. Taste and smell disturbances in patients with gastroparesis and gastroesophageal reflux disease[J]. J Neurogastroenterol Motil, 2017, 23(3): 370-377. doi:10.5056/jnm16132
[25] Masthan K, Vinesh E, Kumar MS, et al. A clinicopathologic study of oral changes in gastroesophageal reflux disease, gastritis, and ulcerative colitis[J]. J Contemp Dent Pract, 2016, 17(11): 943-947. doi:10.5005/jp-journals-10024-1959
[26] Lechien JR, Hans S, De Marrez LG, et al. Prevalence and features of laryngopharyngeal reflux in patients with primary burning mouth syndrome[J]. Laryngoscope, 2021, 131(10): E2627-E2633. doi:10.1002/lary.29604
[27] Hakeem A, Fitzpatrick SG, Bhattacharyya I, et al. Clinical characterization and treatment outcome of patients with burning mouth syndrome[J]. Gen Dent, 2018, 66(3): 41-47
[28] Akinola MA, Oyedele TA, Akande KO, et al. Gastroesophageal reflux disease: prevalence and Extraesophageal manifestations among undergraduate students in South West Nigeria[J]. BMC Gastroenterol, 2020, 20(1): 1-6. doi:10.1186/s12876-020-01292-1
[29] 李东垣. 脾胃论[M]. 北京: 人民卫生出版社, 2005
[30] 李杲. 东垣试效方[M]. 北京: 中国医药科技出版社, 2018: 111
[31] 周之干. 慎斋遗书[M]. 北京: 中国中医药出版社, 2016: 71
[32] 赵献可. 医贯[M]. 北京: 人民卫生出版社, 2005: 90
[33] 周娟, 白兴华, 郭盛楠, 等. 光绪帝胃食管反流病案研究(续)[J]. 中国民间疗法, 2022, 30(3): 6-9. doi:10.19621/j.cnki.11-3555/r.2022.0303
[34] 陈可冀. 清宫医案集成[M]. 北京: 科学出版社, 2009: 820
[35] 白兴华, 郭盛楠, 周娟, 等. 光绪六年慈禧病案: 一个不典型性胃食管反流病的典型案例(上)[J]. 中国民间疗法, 2021, 29(23): 11-15. doi:10.19621/j.cnki.11-3555/r.2021.1204 BAI Xinghua, GUO Shengnan, ZHOU Juan, et al. The case of Cixi in Guangxu six years: a typical case of atypical gastroesophageal reflux disease(I)[J]. China's Naturopathy, 2021, 29(23): 11-15. doi:10.19621/j.cnki.11-3555/r.2021.1204
[36] 马文植. 纪恩录[M]. 北京:中国中医药出版社, 2015:105
[1] Lei WANG,Gang WANG,Wei WU,Hongdan LIU,Bingxin XU,Xin LI,Haolun HAN,Baowei LI,Ruiying DING,Lianyong LI. Simultaneous Dx-pH monitoring of the oropharynx and esophagus for laryngopharyngeal reflux disease research [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 101-106.
[2] LI Zewen, GUO Junyu, ZHOU Jie, YAN Fubo, YANG Zhimin, DING Zhuhua. Relationship between gastroesophageal reflux disease and laryngeal carcinoma: a meta-analysis. [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2016, 30(3): 40-46.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd