岐黄学者张学智教授以病统证、病证结合辨治幽门螺杆菌相关性胃炎的思路和诊疗策略  

Qi Huang Scholar,Professor ZHANG Xuezhi's approach and treatment strategy for Helicobacter pylori-associated gastritis by disease dominating syndrome and combination of disease and syndrome in diagnosis

作　　者：李程程 叶晖[2] 黎巍威[2] 贾晓芬 曹峻文 张学智[2] LI Chengcheng;YE Hui;LI Weiwei;JIA Xiaofen;CAO Junwen;ZHANG Xuezhi(Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing,100700,China;Department of Traditional Chinese Medicine,Department of Integrative Medicine,Peking University First Hospital)

机构地区：[1]北京中医药大学东直门医院,北京100700 [2]北京大学第一医院中医科、中西医结合科

出　　处：《中国中西医结合消化杂志》2024年第10期922-925,933,共5页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：首都卫生发展科研专项(No:首发2022-2-4077);中央高水平医院临床科研专项(No:2022CR64);国家中医药管理局中医药传承与创新“百千万”人才工程-岐黄工程(No:国中医药人教函[2022]6号)。

摘　　要：岐黄学者张学智教授临证诊疗幽门螺杆菌(HP)30余年,对HP相关性胃炎病机动态演绎发展规律进行了系统归纳总结,基于临床随访队列和治疗实践系统探索提出HP相关性胃炎疾病进展遵循“脾胃湿热-脾虚郁滞-正虚邪盛”的病机演变特点,提出“清热调中-培土畅中-扶正攻毒”三步治法,通过以病统证、病证结合针对性实现辨证论治、全程动态随访的中医药治疗,分阶段干预,实现HP相关性胃炎的中西医协作诊疗体系的构建及胃黏膜病变的中医药全程管理,达到延缓疾病进展甚至逆转病变的效果。笔者通过对张学智教授分阶段分层次诊治HP相关性胃炎经验进行探析,以期为临证提供参佐。Qihuang scholar Professor ZHANG Xuezhi,has dedicated over 30 years to the diagnosis and treatment of Helicobacter pylori(HP)-associated gastritis.and has systematically summarized the dynamics of HP-associated gastritis and summarized the law of interpretation and development.He has proposed that the disease progression of HP-associated gastritis should follow the characteristics of disease mechanism evolution of"dampness and heat in the spleen and stomach,spleen deficiency and stagnation,and deficiency of genuine Qi and excess of pathogenic factor".Professor ZHANG introduces a three-tiered treatment strategy:"clearing heat and regulating the middle,""cultivating the soil and unimpeded the middle,"and"supporting the positive and attacking the poison",which enables a disease-syndrome integrated approach,allowing for dynamic follow-up throughout the entire process of TCM treatment,facilitating phased intervention in HP-associated gastritis.By integrating disease and syndrome,the three-step treatment not only realizes targeted intervention and holistic dynamic tracking of TCM therapy but also introduces phased treatment,establishing a collaborative diagnostic and treatment system for HP-associated gastritis that integrates Chinese and Western medicine.This comprehensive approach aims to manage gastric mucosal lesions with TCM,potentially slowing disease progression or even promoting lesion reversal.This article dissects Professor ZHANG Xuezhi's tiered diagnostic and treatment experience with HP-associated gastritis to offer clinical evidence-based references.

关 键 词：HP相关性胃炎 以病统证 病证结合 分期论治 中医经验 

分 类 号：R573.3[医药卫生—消化系统]