目的：总结基于中医理论辨证治疗胃脘灼热的临证经验。方法：通过跟诊学习，整理夏永良的典型医案，结合经典古籍中的相关论述，从疾病病机、主症、治法等方面，总结其辨治胃脘灼热患者的特点与选用经验。结果：胃脘灼热病因病机复杂多变，夏永良认为其主要病因归结为气、火、痰、虚，其病机不离火热。针对肝气犯胃、气郁化火者，治以疏肝和胃，方用柴胡疏肝散加减。痰热互结、气郁不通者，治以清热化痰，兼以制酸解郁，方用小陷胸加枳实合乌贝散加减。若为寒热错杂者，治以辛开苦降以调中，方用半夏泻心汤加减。脾胃气虚、湿阻气滞者，治以益气健脾、燥湿行气，选方香砂六君子加减。而肝胃阴虚者，则治以滋阴疏肝和胃，善用一贯煎加减。结论：夏永良临证治疗胃脘灼热患者时，常从火热论治，主要分为肝胃郁热证、痰热互结证、寒热错杂证、脾虚湿滞证、肝胃阴虚证五大证型，方证相应，并寓调气和血于治疗之中，同时兼顾患者情志，注重行气和胃、肝脾同调，充分体现出“异病同治”的特点，取得明显疗效，值得临床借鉴。

Objective： To summarize the clinical experience of Professor XIA Yongliang in treating gastric burning sensation.Methods： Through following Professor XIA’s outpatient service，sorting typical medical records of fever，lung-distension，gastric distension and hypochondriac pain，combined with interrelated discussions in classics，from the pathogenesis，main syndrome and therapeutic method of the diseases，it summarizes the syndrome and application characteristics of Professor XIA’s experience in treating gastric burning sensation.Results： The etiology and pathogenesis of gastric burning sensation are complex and variable. Xia Yongliang attributes it’s primary causes to qi， fire， phlegm， and deficiency. The pathogenesis consistently involves fire.For cases due to liver qi invading the stomach and qi stagnation transforming into fire， the treatment principle is to soothe the liver and harmonize the stomach， using a modified Chaihu Shugan San.For cases involving phlegm-heat entanglement and qi stagnation causing obstruction， the treatment focuses on clearing heat and resolving phlegm， combined with counteracting acid and relieving stagnation， using a modified Xiao Xianxiong Tang plus Zhishi combined with Wu Bei San.For cold-heat complex disorders， treatment employs opening with pungency and descending with bitterness to regulate the middle jiao， using a modified Banxia Xiexin Tang.For spleen-stomach qi deficiency with dampness obstructing and qi stagnation， treatment aims to tonify qi， fortify the spleen， dry dampness， and move qi， selecting a modified Xiangsha Liujunzi Tang.For liver-stomach yin deficiency， treatment involves nourishing yin， soothing the liver， and harmonizing the stomach， skillfully using a modified Yiguan Jian.Conclusion： In clinical practice， Dr. Xia often approaches the treatment of gastric burning sensation from the perspective of fire pathogenesis， primarily categorizing it into five key patterns： liver-stomach stagnant heat， phlegm-heat binding， cold-heat complexity， spleen deficiency with dampness stagnation， and liver-stomach yin deficiency. His treatments demonstrate a strict correspondence between the pattern and the formula. He incorporates the regulation of qi and blood into the therapy， simultaneously addressing the patient's emotional state， emphasizing moving qi to harmonize the stomach， and concurrently regulating the liver and spleen. This approach fully embodies the characteristic of "different treatments for the same disease". Dr. Xia applies different treatments for the same disease based on precise pattern differentiation and strict correspondence between the pattern and the formula. The clinical outcomes are significant and worthy of reference.