基于辛开苦降法探讨国医大师刘志明治疗慢性胃炎经验  

Exploring Liu Zhiming’s clinical experience in treating chronic gastritis based on the acrid-release and bitter-downbearing therapy

作　　者：耿金珠 王秋铭 刘志明[1] 刘如秀[1] GENG Jin-zhu;WANG Qiu-ming;LIU Zhi-ming;LIU Ru-xiu(Guang'anmen Hospital,Chinese Academy of Traditional Chinese Medicine,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《时珍国医国药》2025年第6期1141-1143,共3页Lishizhen Medicine and Materia Medica Research

基　　金：中国中医科学院科技创新工程学部委员学术传承与传播专项项目(CI2022E012XB);中央高水平中医医院临床研究和成果转化能力提升项目(HLCMHPP2023053);北京中医药薪火传承“新3+3”工程刘志明门人(刘如秀)传承工作站(2023-SZ-G-02);北京中医药薪火传承“新3+3”工程刘志明“三名”传承工作室(2023-SZ-F-06)。

摘　　要：慢性萎缩性胃炎(CAG)是以消化系统常见的慢性疾病,具有病程长、病机复杂、且易复发的特点;该病在中医可归属于胃脘痛、痞满的范畴。发病因素方面,西医学认为,本病的发生大多与幽门螺杆菌感染、胃黏膜壁屏障保护功能减退、自身免疫机制等因素有关,而中医认为该病病因多与素体亏虚、饮食内伤、劳逸失度、情志失调等因素相关。治疗方面,目前西医治疗本病临床疗效欠佳;中医药治疗该病具有独特优势,国医大师刘志明教授认为慢性萎缩性胃炎的发病主要是湿浊内蕴、脾胃失运、气机升降失调,治疗当健脾化湿,恢复脾胃运化及气机升降功能,临床常采用泻心汤加减治疗,疗效显著。Chronic atrophic gastritis(CAG)is a common chronic digestive system disease characterized by a prolonged course,complex pathogenesis,and susceptibility to recurrence.In traditional Chinese medicine(TCM),this condition falls under the categories of“epigastric pain”(胃脘痛)and“distention and fullness”(痞满).Regarding etiology,Western medicine attributes the onset of CAG primarily to factors such as Helicobacter pylori infection,impaired protective function of the gastric mucosal barrier,and autoimmune mechanisms.In contrast,TCM posits that its pathogenesis is closely related to constitutional deficiency,dietary irregularities,improper balance between work and rest,and emotional disorders.In terms of treatment,current Western medical therapies exhibit limited clinical efficacy,while TCM demonstrates unique advantages.Professor Liu Zhiming,a renowned master of TCM,proposes that the core pathogenesis of CAG lies in the internal accumulation of dampness and turbidity,spleen-stomach dysfunction,and disorder of qi movement and regulation.His therapeutic approach emphasizes strengthening the spleen,resolving dampness,and restoring the spleen-stomach's transformative functions and qi regulation,with the modified Xiexin Decoction(泻心汤),achieving remarkable clinical efficacy.

关 键 词：甘草泻心汤 辛开苦降 慢性萎缩性胃炎 刘志明 

分 类 号：R249.2[医药卫生—中医临床基础] R249.7[医药卫生—中医学]