谢晶日教授治疗慢性萎缩性胃炎的经验研究
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摘要
慢性萎缩性胃炎(Chronic Atrophic Gastritis,CAG)是以胃粘膜上皮遭到反复损害后导致的粘膜固有腺体的萎缩甚至消失为病理特点的消化系统的常见病,是慢性胃炎(Chronic Gastritis)的一种类型。临床表现多见上腹部隐痛、胀闷、食欲不振、嗳气等症状,其病理表现以胃粘膜固有腺体萎缩、粘膜变薄、粘膜肌层变厚、胃酸分泌减少为主,常伴有肠上皮化生(intestinal metapIasia,IM)、异型增生(dysplasia,Dys)。
本文根据大量文献资料阐述了慢性萎缩性胃炎的中西医研究进展,从其病因病机、诊断、治疗等方面进行论述,并且从病因病机、辨证、治疗用药等方面总结导师谢晶日教授治疗慢性萎缩性胃炎的思路,并结合导师经治的3例典型慢性萎缩性胃炎患者探讨CAG的诊治。在病因病机上导师认为(1)脾胃气阴两虚是本病的基本发病原因;(2)血瘀热毒是本病的常见致病因素。在治疗上导师认为(1)益气养阴是治疗本病的有效策略;(2)活血解毒是逆转本病的治疗关键。
Chronic Atrophic Gastritis(CAG) is a kind of digestive diseases with the principal pathological characteristics of the inherent glandular atrophy or even disappear caused by repeated damage to gastric mucosal.Upper abdominal pain,bulging nausea,loss of appetite and other symptoms are the clinical manifestations of CAG.And the mainly pathological manifestations are gastric mucosal inner inherent glandular atrophy,thinner gastric mucosa, thicker mucosal musculature,less secretion of gastric acid,and often accompanied by intestinal metaplasia or dysplasia.
According to mass literature data,the development of CAG in integrated medicine is expatiated,and the etiology,pathogenesis,diagnosis and treatment of CAG are discussed.Through research on three CAG patients of professor XIE Jing-ri,thoughts of therapy of CAG is summarized from etiology,pathogenesis,dialectics and therapeutic medication.From etiology and pathogenesis,professor XIE holds that asthenia of the spleen and stomach and insufficiency of Qi and Yin are the immanent cause of CAG,and blood stasis and retention of damp-heat are the fundamental cause of CAG.And from therapy,professor XIE holds that the method of benefiting Qi, nourishing Yin,promoting brood flew and detoxicating is a fundamental method of treating CAG.
本文根据大量文献资料阐述了慢性萎缩性胃炎的中西医研究进展,从其病因病机、诊断、治疗等方面进行论述,并且从病因病机、辨证、治疗用药等方面总结导师谢晶日教授治疗慢性萎缩性胃炎的思路,并结合导师经治的3例典型慢性萎缩性胃炎患者探讨CAG的诊治。在病因病机上导师认为(1)脾胃气阴两虚是本病的基本发病原因;(2)血瘀热毒是本病的常见致病因素。在治疗上导师认为(1)益气养阴是治疗本病的有效策略;(2)活血解毒是逆转本病的治疗关键。
Chronic Atrophic Gastritis(CAG) is a kind of digestive diseases with the principal pathological characteristics of the inherent glandular atrophy or even disappear caused by repeated damage to gastric mucosal.Upper abdominal pain,bulging nausea,loss of appetite and other symptoms are the clinical manifestations of CAG.And the mainly pathological manifestations are gastric mucosal inner inherent glandular atrophy,thinner gastric mucosa, thicker mucosal musculature,less secretion of gastric acid,and often accompanied by intestinal metaplasia or dysplasia.
According to mass literature data,the development of CAG in integrated medicine is expatiated,and the etiology,pathogenesis,diagnosis and treatment of CAG are discussed.Through research on three CAG patients of professor XIE Jing-ri,thoughts of therapy of CAG is summarized from etiology,pathogenesis,dialectics and therapeutic medication.From etiology and pathogenesis,professor XIE holds that asthenia of the spleen and stomach and insufficiency of Qi and Yin are the immanent cause of CAG,and blood stasis and retention of damp-heat are the fundamental cause of CAG.And from therapy,professor XIE holds that the method of benefiting Qi, nourishing Yin,promoting brood flew and detoxicating is a fundamental method of treating CAG.
引文
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[4]董淑平.马山教授治疗慢性萎缩性胃炎经验[J].河北中医药学报.2001,16(3):41.
[5]王利峰.朱振华治疗慢性萎缩性胃炎经验[J].江西中医药.2009,40(313):28-29.
[6]余瑞英.滋阴化瘀法治疗慢性萎缩性胃炎临床观察[J].中医药学刊.2002,18(1):13.
[7]张杰,章天寿.从“虚”“毒”“瘀”论治慢性萎缩性胃炎[J].中国中医基础医学杂志,2005,11(1)44-45.
[8]魏凤琴.解毒祛瘀、疏肝和胃法治疗慢性萎缩性胃炎的体会[J].江苏中医药.2005,26(10):56-57.
[9]张纹,娄莹莹,史纯纯.李佃贵教授从浊毒论治慢性萎缩性胃炎经验介绍[J].新中医,2009,41(1):8-10.
[10]王德莉,唐君.吴立文从湿辨治胃痞的临证经验[J].辽宁中医杂志.,2008,35(7):977-978.
[11]许兰兰.慢性萎缩性胃炎从“燥”论治[J].中国现代医生,2008,46(23):80-81.
[12]江绍基主编.胃肠病学[M].上海:上海科学技术出版社,2001,358-365.
[13]Sanduleanu S,Hameeteman W,et al,Doubleinfection of the stomach with hlicobacter pylori and non-Helicobacte rpylori bacteria acause for the development to fatrophic gastritiss during acid-suppressive therapy[J].European Journalof Gastroenterology and Hepatology.2001,13(12):A1-A2.
[14]Hirano,Atsuyoshi,Yanai,et al.Evaluation of Epstein-Barr Virus DNA load in Gastric Mucosa with Chronic Atrophic Gastritis Using a Real-Time Quantitative PCRA ssay[J].International Journal of Gastrointestinal Cancer.2003,34(2-3):87-94.
[15]杨鸿,候家玉.胆汁反流致慢性萎缩性胃炎的实验研究[J].北京中医药大学学报,2001,24(5):26-28.
[16]Tsukui,T Kashiwagi,Sakane Retal.Aging increases,and duodenal ulcer reduces the risk for intestinal metaplasia of the gastriccorpus in Japanese patients with dyspepsia[J].Journal of Gastroenterology and Hepatoiogy,2001,16(1):15-21.
[17]杨国平,李敏,孙益,等.百名名中医治疗慢性萎缩性胃炎临床经验资料的计算机分析研究[J]. 中国中医基础医学杂志,2008,14(1):62-63.
[18]陈良金.慢性萎缩性胃炎辨证分型与治法特点探折[J].时珍国医国药,2005,16(11):1149.
[19]黎进荣,吕学武.辨证治疗慢性萎缩性胃炎36例临床观察[J].辽宁中医杂志,2005,32(2):117-118.
[20]蒋永光,王黎民,肖金等.成方配伍治疗慢性萎缩性胃炎疗效观察[J].辽宁中医杂志,2005,32(1):15-16.
[21]周信有.慢性萎缩性胃炎的辨治经验[J].世界中医药,2007,2(2):101-102.
[22]刘西峰,白丽萍,米新.辨证治疗慢性萎缩性胃炎96例[J].陕西中医,2004,25(1):8-9.
[23]魏道祥.辨证分型治疗慢性萎缩性胃炎1276例[J].山东中医杂志,2003,22(11):673-674.
[24]赵民,齐金刚.辨证治疗慢性萎缩性胃炎32例临床观察[J].陕西中医,2007,28(9):1147-1148.
[25]杜艳茹,白海燕,孙振胜.李建新治疗慢性萎缩性胃炎的经验[J].辽宁中医杂志,2006,33(12):1546-1547.
[26]袁福宁.辨证论治慢性萎缩性胃炎50例[J].光明中医,2006,21(4):59-60.
[27]高富贵.慢性萎缩性胃炎中医辨证治疗108例[J].医学理论与实践,2004,17(8):908-909.
[28]马秀萍.膈下逐瘀汤治疗慢性萎缩性胃炎临床观察[J].四川中医,2004,22(8):60-61.
[29].王万卿,王岩,王晟.半夏厚朴汤加味治疗慢性萎缩性胃炎68例疗效观察[J].四川中医,2006,24(8):60-61.
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