实用中医内科杂志2025，Vol.39Issue(9)：11-14,4.DOI:10.13729/j.issn.1671-7813.Z20231878
基于"既病防变"探讨慢性萎缩性胃炎辨治思路
Exploring the Differentiation and Treatment of Chronic Atrophic Gastritis Based on the Theory of"Preventing Disease from Exacerbating"
摘要
Abstract
The theory of"preventive treatment of diseases"in Traditional Chinese Medicine(TCM)includes"prevention be-fore disease onset","preventing disease from exacerbating"and"prevention disease recurrence".The connotation of"preven-ting disease from exacerbating"includes early diagnosis and treatment and prevention of transmission.Chronic atrophic gastritis(CAG)is a common and frequently occurring disease in clinic.CAG with intestinal metaplasia and dysplasia is a hot and diffi-cult topic in the prevention and treatment of gastric cancer,namely gastric precancerous state.The key of gastric precancerous state is to grasp the development regularity and characteristics of pathogenesis of TCM disease of CAG.The syndrome of CAG is mostly intermingled deficiency and excess,deficient root and excessive superficial.The lesion sites of CAG are mainly the spleen and stomach,and liver and kidney may be involved.The deficiency syndrome mainly consists of qi deficiency,Yang deficiency and Yin deficiency,and the excess syndrome mainly consists of qi stagnation.When accompanied by IM,Dys or microscopic vascular penetration,mucosal granular hyperplasia or nodular appearance,The gastric collaterals were considered to contain the pathological products of dampness-heat,blood stasis and phlegm-dampness.The application of the theory of"prevention and treatment of existing diseases"in the clinical diagnosis and treatment of CAG focuses on grasping the three stages of disease ger-mination,development,and recovery.In the embryonic stage,it is necessary to recognize the whole through observation of the part,make early diagnosis and treatment and pay attention to the combination of TCM and Western medicine,"three views"for treatment,and make use of the idea of syndrome elements differentiation to closely observe the essence of the disease.At the stage of development,it is necessary to strengthening vital qi to eliminate pathogenic factor,prevent transmission of changes,and always treat spleen-invigorating qi,dissipating phlegm and dispersing blood stasis.In the recovery stage,attention should be paid to preventing recurrence and strengthening body resistance to eliminate pathogenic factors.The method of fortifying the spleen and replenishing qi,warming Yang and supplementing Yin should be taken as the method of consolidating the constitu-tion;removing all stagnation as the treatment of resisting pathogenic factors.The comprehensive and focused treatment based on differentiation of symptoms and signs throughout the entire course of the disease can help improve the clinical efficacy of CAG dif-ferentiation and timely curb the trend of gastric mucosal malignancy.关键词
治未病/既病防变/慢性萎缩性胃炎Key words
preventive treatment of diseases/preventing disease from exacerbating/chronic atrophic gastritis分类
医药卫生引用本文复制引用
黄铭涵,何友成,陈琴,林尧..基于"既病防变"探讨慢性萎缩性胃炎辨治思路[J].实用中医内科杂志,2025,39(9):11-14,4.基金项目
国家自然科学基金项目(82174365) （82174365）
福建省自然科学基金项目(2025J01885) （2025J01885）
福建省卫生健康委员会重点项目(20252DA002) （20252DA002）
