刘铁军辨治慢性萎缩性胃炎
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摘要
刘铁军教授认为,慢性萎缩性胃炎应该以毒损胃络立论,脾胃虚损是慢性萎缩性胃炎的发病基础,而寒邪是慢性萎缩性胃炎的主要病理因素,肝郁贯彻在胃炎的整个过程,三者共同作用,滋生毒邪,毒损胃络,导致了慢性萎缩性胃炎的发生、发展,在继承前人经验、学识的基础上,结合多年临床经验,主张以温阳通络,肝胃同治为基本治则,临证以方证为主导,予经典方剂合方加味应用,在运用温中补虚、散寒通络的方剂时,配合疏肝解郁之法,提倡中医下法在慢性萎缩性胃炎治疗中的运用,常以小剂量大黄起逐毒邪外出之效,逆转或阻断胃黏膜肠上皮化生和不典型增生,体现"已病防变"的中医"治未病"特点。
According to Professor Liu Tiejun, chronic atrophic gastritis should be treated on a basis of poison damage to stomach collaterals, spleen and stomach de ciency is an important pathogenesis of chronic atrophic gastritis, and cold pathogen is the main pathologic factor of chronic atrophic gastritis. Tonifying de ciency in the use of temperature, invigorating the circulation, prescription with liver resolve depression of the party, and promoting the traditional Chinese medicine branch in use in the treatment of chronic atrophic gastritis, often with small dose of Dahuang(rhubarb) by poison evil out of work, to reverse or blocking intestinal metaplasia and atypical hyperplasia of gastric mucosa, re ect "preventing transform when sickness" Chinese medicine "cure not ill" characteristics.
According to Professor Liu Tiejun, chronic atrophic gastritis should be treated on a basis of poison damage to stomach collaterals, spleen and stomach de ciency is an important pathogenesis of chronic atrophic gastritis, and cold pathogen is the main pathologic factor of chronic atrophic gastritis. Tonifying de ciency in the use of temperature, invigorating the circulation, prescription with liver resolve depression of the party, and promoting the traditional Chinese medicine branch in use in the treatment of chronic atrophic gastritis, often with small dose of Dahuang(rhubarb) by poison evil out of work, to reverse or blocking intestinal metaplasia and atypical hyperplasia of gastric mucosa, re ect "preventing transform when sickness" Chinese medicine "cure not ill" characteristics.
引文
[1]高奎亮,李吉彦,解建国.慢性萎缩性胃炎伴肠上皮化生中医治疗进展[J].山东中医药大学学报, 2018, 42(4):363.
[2]张晓倩,鲁重美.幽门螺杆菌感染、慢性萎缩性胃炎与胃癌[J].临床消化病杂志, 2016, 28(3):192-195.
[3]赵欢,杨巧芳.名中医治疗慢性萎缩性胃炎病因病机思路与用药规律[J].时珍国医国药, 2018(6):1518-1520.
[4]李军祥,陈誩,吕宾,等.慢性萎缩性胃炎中西医结合诊疗共识意见(2017年)[J].中国中西医结合消化杂志, 2018,26(2):121-131.
[5]徐坤福.中医药治疗慢性萎缩性胃炎的研究进展[J].光明中医, 2018, 33(14):2140-2142.
[6]张田仓.“久病入络”学说发展的历史渊源[J].中医研究,2015, 28(2):3-5.
[7]张云松,曹志群,张珊珊,等.从毒瘀虚论治慢性萎缩性胃炎癌前病变[J].中华中医药学刊, 2016, 34(10):2390-2392.
[8]刘永年,黄永澄,朱翔,等.疑难病临床家傅宗翰诊治慢性萎缩性胃炎的经验[J].江苏中医药, 2016, 48(5):1-5.
[9]周宝宽,李德新.饮食劳倦与脾胃损伤理论探析[J].辽宁中医杂志, 2003(3):178-179.
[10]宫晓燕.任继学教授从伏邪论治肺系疾病[C]//第十次全国中西医结合防治呼吸系统疾病学术研讨会论文集.杭州:中国中西医结合呼吸病专业委员会, 2009:3.
[11]张世芳.慢性胃炎中医病因之我见[J].光明中医, 2011,26(6):1225-1226.
[12]张景洲,李济同,刘铁军.重视疏肝解郁法在治疗消化系统心身疾病中的应用[J].中国药物经济学, 2013(S1):102-103.
[13]王汉,熊壮,邹文爽,等.刘铁军教授运用经方辨证组合治疗肝病经验[J].中西医结合肝病杂志, 2017, 27(2):111-112.
[14]冷炎,常玲,刘彦晶.腑气不降状态下的脾胃病论治[J].中国民间疗法, 2016, 24(1):11-12.
[15]熊壮,刘扬扬,刘亚洲,等.刘铁军教授应用“下法”治疗肝病思想解析[J].时珍国医国药, 2017, 28(3):716-717.
[2]张晓倩,鲁重美.幽门螺杆菌感染、慢性萎缩性胃炎与胃癌[J].临床消化病杂志, 2016, 28(3):192-195.
[3]赵欢,杨巧芳.名中医治疗慢性萎缩性胃炎病因病机思路与用药规律[J].时珍国医国药, 2018(6):1518-1520.
[4]李军祥,陈誩,吕宾,等.慢性萎缩性胃炎中西医结合诊疗共识意见(2017年)[J].中国中西医结合消化杂志, 2018,26(2):121-131.
[5]徐坤福.中医药治疗慢性萎缩性胃炎的研究进展[J].光明中医, 2018, 33(14):2140-2142.
[6]张田仓.“久病入络”学说发展的历史渊源[J].中医研究,2015, 28(2):3-5.
[7]张云松,曹志群,张珊珊,等.从毒瘀虚论治慢性萎缩性胃炎癌前病变[J].中华中医药学刊, 2016, 34(10):2390-2392.
[8]刘永年,黄永澄,朱翔,等.疑难病临床家傅宗翰诊治慢性萎缩性胃炎的经验[J].江苏中医药, 2016, 48(5):1-5.
[9]周宝宽,李德新.饮食劳倦与脾胃损伤理论探析[J].辽宁中医杂志, 2003(3):178-179.
[10]宫晓燕.任继学教授从伏邪论治肺系疾病[C]//第十次全国中西医结合防治呼吸系统疾病学术研讨会论文集.杭州:中国中西医结合呼吸病专业委员会, 2009:3.
[11]张世芳.慢性胃炎中医病因之我见[J].光明中医, 2011,26(6):1225-1226.
[12]张景洲,李济同,刘铁军.重视疏肝解郁法在治疗消化系统心身疾病中的应用[J].中国药物经济学, 2013(S1):102-103.
[13]王汉,熊壮,邹文爽,等.刘铁军教授运用经方辨证组合治疗肝病经验[J].中西医结合肝病杂志, 2017, 27(2):111-112.
[14]冷炎,常玲,刘彦晶.腑气不降状态下的脾胃病论治[J].中国民间疗法, 2016, 24(1):11-12.
[15]熊壮,刘扬扬,刘亚洲,等.刘铁军教授应用“下法”治疗肝病思想解析[J].时珍国医国药, 2017, 28(3):716-717.