田旭东从“脾虚肝郁络瘀”论治慢性萎缩性胃炎  

Tian Xudong′s Treatment of Chronic Atrophic Gastritis from Perspective of"Spleen Deficiency,Liver Qi Depression and Colleteral Blood Stasis"

作　　者：梁建慧 田旭东[2] 马吾生 LIANG Jianhui;TIAN Xudong;MA Wusheng(Gansu University of Chinese Medicine,Lanzhou Gansu China 730000;Gansu Provincial Hospital of Chinese Medicine,Lanzhou Gansu China 730050)

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]甘肃省中医院,甘肃兰州730050

出　　处：《中医学报》2024年第4期793-797,共5页Acta Chinese Medicine

基　　金：甘肃省名中医传承工作室项目{国中医药规财函[2021]242号}。

摘　　要：慢性萎缩性胃炎病机主要为脾虚失运,肝气郁结不畅,胃络瘀阻,导致腺体失养而萎缩。其依据胃镜及病理结果,将慢性萎缩性胃炎分为单纯慢性萎缩性胃炎期、慢性萎缩性胃炎伴胆汁反流期、慢性萎缩性胃炎伴增生期或(和)肠化期,并严辨各期病机转化。临证时,总体上以经络学说为纲辨治该病,将中医宏观辨证和胃镜及病理组织微观辨证相结合,针对病机分期施治,初期以养络为主,运脾以化生气血,滋养胃络;中期以通络为主,疏肝通络以祛标实;后期养络、通络相结合,祛瘀以生新血,益气通络。The main pathogenesis of chronic atrophic gastritis is Spleen deficiency with poor function in transmission,Liver Qi stagnation and stasis obstruction in Stomach meridians,leading to loss of nourishment and atrophy of the glands.Based on gastroscopy and pathological results,chronic atrophic gastritis is divided into simple chronic atrophic gastritis stage,chronic atrophic gastritis with bile reflux stage,chronic atrophic gastritis with proliferation stage or(and)intestinal metaplasia stage,and the pathological transformation of each stage is strictly distinguished.When treating the disease,the overall principle is based on the theory of meridians and collaterals,combining the macroscopic differentiation of traditional Chinese medicine with the microscopic differentiation of gastroscopy and pathological tissues,and treating it in stages according to the pathogenesis.In the initial stage,the main focus is on nourishing the meridians,since the Spleen is used to transform and generate Qi and blood,nourishing the Stomach meridians;In the middle stage,the main focus is on unblocking the meridians,while soothing the Liver Qi and unblocking the meridians is to dispel excess symptoms;Combining nourishing and unblocking the meridians in the later stage,dispelling blood stasis to generate new blood,nourishing Qi and unblocking the meridians.

关 键 词：慢性萎缩性胃炎 脾虚肝郁络瘀 养络 通络 清络 田旭东 

分 类 号：R256.3[医药卫生—中医内科学]