运用通降理论诊治慢性胃炎的思路与方法  

Diagnosis and Treatment of Chronic Gastritis based on Unblocking and Purging Theory

作　　者：吴皓萌 王凤云[2] 张佳琪 马祥雪 唐旭东[3] WU Haomeng;WANG Fengyun;ZHANG Jiaqi;MA Xiangxue;TANG Xudong(The Second Affiliated Hospital of Guangzhou University of Chinese Medicine/Guangdong Province Hospital of Traditional Chinese Medicine,Guangzhou,510120;Xiyuan Hospital,China Academy of Chinese Medical Sciences;China Academy of Chinese Medical Sciences)

机构地区：[1]广州中医药大学第二附属医院/广东省中医院,广东省广州市510120 [2]中国中医科学院西苑医院 [3]中国中医科学院

出　　处：《中医杂志》2021年第6期485-487,504,共4页Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划(2017YFC1700601);国家中医药管理局中医药行业科研专项(201407001-12)。

摘　　要：通降理论认为,胃腑生理上"以通为用,以降为顺",病理上"因滞致病",治疗上应"以通祛疾"。继承发扬通降理论,总结其用于诊治慢性胃炎的经验主要为辨证时需重点辨脏腑以明病位,辨虚实以察病证性质,辨寒热以察胃腑状态,辨气血以审病位深浅;治疗时既要根据患者临床表现,结合脾与胃生理与病理上的差异,有侧重地脾胃分治,又要鉴别纳运失调、升降失序和润燥不济等"脾胃同病"的病理状态,选择脾胃合治。In unblocking and purging theory, qi movement in stomach should be unblocked as the stomach function well in directing counterflow downward and lower qi;the obstruction of qi movement may lead to pathological diseases;therefore, the treatment should follow the "dispelling diseases through unblocking" principle. This paper summarized the experience of diagnosing and treating chronic gastritis based on unblocking and purging theory, trying to provide references for future clinical practice. Zang-fu pattern differentiation is suggested to identify the location of disease, while deficiency-excess pattern differentiation was advised for nature identification;cold-heat patterns help detecting the status of stomach, and qi-blood patterns reflect the depth of the disease location. During treatment, separate emphasis should be laid on spleen and stomach, with the aid of patients′ clinical manifestations and the know-ledge on physiology and pathology differences;simultaneously, spleen and stomach should be treated in combination, when there is "disease of both spleen and stomach", manifested as failing to receive and transport food, ascend and descend qi, and moisten dryness.

关 键 词：慢性胃炎 通降理论 脾胃病 

分 类 号：R259[医药卫生—中西医结合]