运用“调中复衡”理论诊治慢性萎缩性胃炎的思路与方法  

Ideas and methods about diagnosis and treatment of chronic atrophic gastritis based on the theory of‘harmonizing the centre to restore balance’

作　　者：郭晓雪 王萍[2] 张北华[2] 王凤云[2] 唐旭东[2] GUO Xiaoxue;WANG Ping;ZHANG Beihua;WANG Fengyun;TANG Xudong(Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China;Institute of Digestive Diseases,Xiyuan Hospital of CACMS,Beijing 100091,China)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中国中医科学院西苑医院脾胃病研究所,北京100091

出　　处：《中华中医药杂志》2024年第4期1858-1863,共6页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家中医药传承创新团队项目(No.ZYYCXTD-C-202010);中国中医科学院中央级公益性科研院所基本科研业务费课题(No.ZZ13-024-2);中医药传承与创新“百千万”人才工程(岐黄工程)岐黄学者(No.国中医药人教发〔2018〕12号)。

摘　　要：慢性萎缩性胃炎(CAG)是消化系统的常见病、多发病、难治病之一。“调中复衡”理论是唐旭东教授在继承董建华院士“通降论”学术思想的基础上,结合长期脾胃病临证经验而提出的脾胃病治疗理论,以恢复气机升降和脏腑功能平衡为目的。基于脾胃生理、病理特点和“调中复衡”理论,认为脾虚是CAG的发病根本,气滞是CAG的发病关键,血瘀是CAG的进展特征,临床辨治CAG应以“调中”为基础,以“复衡”为目标,以“八纲通胃法”为具体抓手,要点在于辨脏腑以明疾病定位,多脏同调;辨虚实以明邪正盛衰,补泻兼施;辨气血以明疾病深浅,调气和血;辨寒热以明疾病性质,辛开苦降,从上述4个维度进行辨证论治,病证结合,指导遣方用药,对于CAG的临床治疗具有重要意义。Chronic atrophic gastritis(CAG)is one of the common,frequently occurring and refractory diseases of the digestive system.On the basis of inheriting the academic thought of‘unblocking and purging theory’with proposed by academician DONG Jianhua and combined with the long-term clinical experience,the theory of‘harmonizing the centre to restore balance’is proposed by professor TANG Xudong for the treatment of spleen and stomach diseases,aiming at restoring the balance of qi movement and zang-fu function.Based on physiological and pathological characteristics of the spleen and stomach and the theory of‘harmonizing the centre to restore balance’,it is considered spleen deficiency is the fundamental pathogenesis of CAG,qi stagnation is the key to the onset of CAG,and blood stasis is the progressive characteristic of CAG.Clinical diagnosis and treatment of CAG should be based on‘regulating the middle’,with‘compound balance’as the target,and‘eight principles of unblocking stomach’as the specific gripper.The key points are to distinguish zang-fu to clarify the location of the disease,adjust multiple organs at the same time;to distinguish deficiency-excess to identify healthy energy-evil struggle,combine tonification and purgation;to distinguish qi-blood to clarify the depth of the disease,regulate qi and blood;to distinguish cold-heat to identify the nature of disease,acrid opening and bitter downbearing.It is of great significance for the clinical treatment of CAG to treat syndrome differentiation from the above four dimensions,combine disease and syndrome,and guide prescription medication.

关 键 词：慢性萎缩性胃炎 调中复衡 脾胃病 通降论 理论探讨 

分 类 号：R259[医药卫生—中西医结合]