张树本诊治慢性萎缩性胃炎临证经验介绍  

Introduction of ZHANG Shuben's Clinical Experience in Diagnosis and Treatment of Chronic Atrophic Gastritis

作　　者：陈奎铭 张前梅 CHEN Kuiming;ZHANG Qianmei(Chongqing Kaizhou Hospital of Traditional Chinese Medicine,Chongqing 405400,China)

机构地区：[1]重庆市开州区中医院,重庆405400

出　　处：《新中医》2025年第6期181-187,共7页New Chinese Medicine

基　　金：张树本全国基层名老中医药专家传承工作室项目;重庆市开州区2022年第二批科技指导性计划项目(2022-Z-01-22);重庆市开州区2022年第二批科技指导性计划项目(2022-Z-01-13)。

摘　　要：介绍张树本名老中医诊疗慢性萎缩性胃炎的临床经验。张树本认为,逆转萎缩的胃黏膜是慢性萎缩性胃炎治疗的重点,辨证强调首辨病、再辨证、病症结合;通过舌诊宏观把握,结合胃镜微观调控,因人制宜,诊断强调首宏观、再微观、衷中参西;据病情发展情况分三阶段治疗,第一阶段疏肝健脾、消除症状,第二阶段健脾和胃、逆转萎缩,第三阶段调理巩固、改善体质,治疗强调首阶段、再个体、因人制宜;以疏肝理气为第一要义,疏肝健脾为准则,选用四逆散合平胃散,加减清热解毒、活血散结、温补脾肾、制酸散结等对药,遣方用药强调首汤剂、再膏方、守法守方,标本兼顾。This paper introduces famous Chinese medicine physician ZHANG Shuben's clinical experience in the diagnosis and treatment of chronic atrophic gastritis.According to ZHANG Shuben,reversing atrophic gastric mucosa is the key point in the treatment of chronic atrophic gastritis.Syndrome differentiation emphasizes the first differentiation of disease and the second syndrome,and their combination;individualized treatment is given after macroscopic grasp by tongue diagnosis combined with the microscopic regulation by gastroscopy.The diagnosis highlights first the macrocosm,followed by microcosm,that is,the integration of Chinese and western medicine;according to the development of the disease,it is divided into three stages of treatment.The first stage is to soothe the liver and fortify the spleen and eliminate the symptoms.The second stage is to fortify the spleen and harmonize the stomach and reverse atrophy.The third stage is for conditioning and consolidation and the improvements in the constitution.The treatment stresses the first stage,then the individual and the individualized treatment;with soothing the liver and rectifying qi as the first,soothing the liver and fortifying the spleen as the principle,Sini Powder and Pingwei Powder were selected in combination with modified medicinal pairs for clearing heat and detoxifying,activating blood and dissipating masses,warming and supplementing the spleen and kidney,and controlling acid and dissipating masses.The prescriptions and medication focus on the first decoction prescription,followed by soft extract prescription,maintaining the treatment with a certain prescription and dealing with both the root and branch of the disease.

关 键 词：慢性萎缩性胃炎 分阶段论治 舌诊 胃镜象 疏肝理气 张树本 

分 类 号：R249[医药卫生—中医临床基础] R573.32[医药卫生—中医学]