谢晶日教授治疗脾胃虚寒型复合型消化性溃疡临证经验  

Clinical experience of Professor Xie Jingri in treating deficiency-cold of spleen and stomach type of complex peptic ulcer

作　　者：蔡宏波[1] 王海强[1] 蔡宏宇 李昊霖 梁国英[1] CAI Hong-bo;WANG Hai-qiang;CAI Hong-yu;LI Hao-lin;LIANG Guo-ying(The First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin 150040,China;Harbin Hospital of Traditional Chinese Medicine,Harbin 150010,China;Changchun University of Science and Technology,Changchun 130600,China)

机构地区：[1]黑龙江中医药大学附属第一医院,黑龙江哈尔滨150040 [2]哈尔滨市中医医院,黑龙江哈尔滨150010 [3]长春科技学院,吉林长春130600

出　　处：《海南医学院学报》2022年第2期148-151,共4页Journal of Hainan Medical University

基　　金：2016年全国名老中医药专家传承工作室建设项目[国中医药人教发(2016)42号];第六批全国老中医药专家学术经验继承工作项目[国中医药人教发〔2017〕29号];黑龙江省博士后科研启动项目(LBH-Q17169);全国中医临床特色技术传承骨干人才培训项目[国中医药人教函〔2019〕36号]。

摘　　要：介绍谢晶日教授治疗脾胃虚寒型复合型消化性溃疡的临证经验总结。谢教授认为,该病多由脾胃素虚,寒邪易侵以及中焦虚寒,失于温养导致。患者如若脾胃素虚,或中阳不足,均可导致脾胃纳运失调、胃气壅滞而生痞满。而脾胃虚弱,易受寒邪,中焦气机不畅,亦可导致虚寒内生而凝滞,加之患者平素如若饮食不节、饥饱失常、过食生冷、防护失宜等,均可导致脾胃阳气的虚衰,进而使得中焦失于温养,复伤脾胃运化之功,而发胃脘冷痛胀满。故在治疗方面,以温中散寒为主,行气止痛为辅;临床上常用散寒止痛、理气和胃之小茴香、炮姜、柴胡、佛手、香橼,以及温中行气之豆蔻等品。而患者脾胃虚衰,故将补益脾胃贯穿疾病治疗的始终,在临床治疗中,常用黄芪、焦白术、陈皮等补益脾气、行气和胃之品,临床取得较显著疗效,值得临床进一步借鉴与应用。This paper introduces the clinical experience of Professor Xie Jingri in the treatment of deficiency-cold of spleen and stomach type of complex peptic ulcer.According to Professor Xie,chronic non-atrophic gastritis with duodenal ulcer is mainly caused by deficiency of spleen and stomach element,invasion of cold pathogenic factors and deficiency of cold in the middle-jiao.If the patients have deficiency of spleen and stomach element,or deficiency of middle-yang,it can lead to maladjustment of spleen and stomach transportation,stagnation of stomach qi,fullness of ruffles,weakness of spleen and stomach,susceptibility to cold pathogen,poor qi mechanism of middle-jiao and stagnation of deficiency and cold due to internal generation.In addition,if the pa-tients have poor diet,abnormal hunger and satiety,cold due to overeating,improper protection,etc.,it can lead to deficiency and failure of spleen and stomach yang qi,and then make middle-jiao lose its temperature nourishing,injure the function of spleen and stomach transportation,and make stomach cold,painful and full.Therefore,in the aspect of treatment,Professor Xie also takes“warming spleen and stomach for dispelling cold”as the main treatment,“promoting qi circulation to relieve pain”as the auxilia-ry,and invigorates the spleen.In clinical practice,fennel,processed ginger,bupleurum,bergamot,citron,et al.are commonly used for dispersing cold to relieve pain and for regulating qi-flowing to harmonize stomach,and additionally cardamom is used for warming and promoting qi.For the patients suffering from spleen and stomach deficiency and decline,it is necessary to strengthen the spleen and stomach throughout the treatment.In clinical treatment,it needs tonic products to nourish spleen,qi and stomach,such as Astragalus membranaceus,white Atractylodes rhizome and tangerine peel.The clinical effect is more significant,which is worthy of further reference and application.

关 键 词：复合型消化性溃疡 脾胃虚寒 谢晶日教授 临证经验 

分 类 号：R259[医药卫生—中西医结合] R249[医药卫生—中医内科学]