中医药学报2025，Vol.53Issue(9)：53-58,6.DOI:10.19664/j.cnki.1002-2392.250187
基于"玄府-气液-络脉"探讨慢性萎缩性胃炎的分期辨治
Discussion on Staged Pattern Differentiation and Treatment of Chronic Atrophic Gastritis Based on the"Xuanfu-Qi-Liquid-Collaterals"Theory
摘要
Abstract
Chronic atrophic gastritis(CAG)is a chronic digestive system disease characterized by atrophy of the gastric mucosal epithelium and glands,and its pathogenesis is closely related to the"Xuanfu-Qi-Liquid-Collaterals"theory.Based on this theory,this study deeply discusses the physiological functions of the stomach,and combines the clinical manifestations at different stages of CAG and the pathological changes of the mucosa under gastroscopy,proposing that the pathogenesis of CAG may be related to Xuanfu stagnation and blockage and failure of the stomach to be nourished,while Qi-Liquid disharmony and earth excess with wood depression(spleen/stomach disorder affecting the liver)may be the key links of the lesion,and prolonged pain entering the collaterals and stasis-toxin damaging the healthy qi may be the result of disease progression.Furthermore,based on the treatment principle of"Unblocking the Xuanfu-Diffusing Qi and Liquids-Activating Blood and Dredging Collaterals",a staged pattern differentiation and treatment strategy for CAG is proposed.In the simple CAG stage,the treatment should focus on regulating qi to open the Xuanfu and nourishing the stomach,using modified Xiangsha Liujunzi Decoction combined with Yiwei Decoction.In the CAG with bile reflux stage,the treatment should resolve dampness and eliminate fullness,soothe the liver and harmonize the stomach,using modified Banxia Xiexin Decoction combined with Shaoyao Gancao Decoction.In the CAG with intestinal metaplasia stage,the treatment should activate blood and dredge collaterals,clear heat and resolve toxin,using modified Shixiao Powder combined with Xianfang Huoming Drink.During the treatment process,the flexible application of acrid herbs to unblock the Xuanfu,aromatic herbs to diffuse Qi and Liquids,and insect drugs to activate blood and dredge collaterals,helps to dissipate tangible pathogens in the stomach collaterals such as water-dampness,phlegm-turbidity,and stasis-toxin,providing new clinical ideas for the treatment of CAG with Traditional Chinese Medicine.关键词
慢性萎缩性胃炎/玄府/气液/络脉/分期辨治Key words
Chronic atrophic gastritis/Xuanfu/Qi-Liquid/Collaterals/Staged pattern differentiation and treatment分类
医药卫生引用本文复制引用
李雪齐,胡晓阳..基于"玄府-气液-络脉"探讨慢性萎缩性胃炎的分期辨治[J].中医药学报,2025,53(9):53-58,6.基金项目
国家自然科学基金青年基金项目(82004245) （82004245）
国家中医药管理局全国名老中医药专家传承工作室建设项目——李冀全国名老中医药专家传承工作室(国中医人发[2014]20号) （国中医人发[2014]20号）
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)岐黄学者项目(国中医药人教函[2018]284号) （岐黄工程）
黑龙江省青年岐黄学者培养项目(黑中医药教函[2023]36号) （黑中医药教函[2023]36号）
