噎膈
Alias食管梗阻
Traditional Chinese Medicine Definition
Yī Gé (Esophageal Obstruction), a disease category within Traditional Chinese Medicine (TCM) pertaining to the spleen and stomach system, refers to a condition characterized by the narrowing and obstruction of the esophagus, leading to difficulty in swallowing. According to the "Internal Medicine of Traditional Chinese Medicine," the pathogenesis of Yī Gé is often attributed to factors such as the obstruction of phlegm and Qi, deficiency of body fluid with heat conglomeration, and is manifested by symptoms such as difficulty in swallowing, chest and diaphragm stuffiness, etc.
In clinical practice of TCM, the pathogenesis of Yī Gé primarily involves the obstruction of phlegm and Qi and the deficiency of body fluid with heat conglomeration. Common precipitating factors include improper diet, emotional disturbances, and chronic weakness. During the process of differentiation, it is essential to differentiate between the obstruction of phlegm and Qi and the deficiency of body fluid with heat conglomeration. The obstruction of phlegm and Qi is mainly manifested by difficulty in swallowing, chest and diaphragm stuffiness, with symptoms slightly alleviated when the emotions are at ease. In contrast, the deficiency of body fluid with heat conglomeration presents with difficult and painful swallowing, difficulty in ingesting solid food, and dry mouth and throat. In terms of treatment, traditional Chinese medicine suggests regulating Qi and opening up stagnation, resolving phlegm and moistening dryness to treat the obstruction of phlegm and Qi, and nourishing Yin and blood, moistening dryness and generating body fluid to treat the deficiency of body fluid with heat conglomeration. Overall, the adjustment of Yī Gé should focus on harmonizing the spleen and stomach, moistening and unblocking the meridians, in order to alleviate symptoms and improve the narrowing of the esophagus.
Common Syndrome Types and Key Points of Differentiation
痰气交阻证
Main Manifestations：吞咽梗阻，胸膈痞满，情志舒畅时稍减
Management Approach：理气开郁，化痰润燥
津亏热结证
Main Manifestations：吞咽梗涩而痛，固体食物难入，口干咽燥
Management Approach：滋阴养血，润燥生津
The above syndrome information is based on traditional Chinese medicine textbooks and clinical standards. Specific differentiation should be completed by a practicing traditional Chinese medicine physician in person.
Physician's Clinical Insights
Observing Yī Gé patients often reveals dark facial complexion and purple tongue, indicating a need for activating blood and removing blood stasis to relieve the obstruction.
— 唐玉兰 中医执业医师（师承）
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参考文献：《中医内科学》（十三五规划教材）、《中医病证诊断疗效标准》(ZY/T001.1-94)、《中医病证分类与代码》(GB/T 15657-2021)