三型辨证结合胃镜下辨证论治慢性萎缩性胃炎

Application of three syndrome types combined with gastroscope into the differentiation of chronic atrophic gastritis

目前常用的慢性萎缩性胃炎(CAG)中医辨证分型较复杂,且未能结合电子胃镜对胃黏膜进行镜下辨证施治。笔者把CAG按病机主要分型为脾胃气虚(阳虚)证、肝胃气滞(不和)证、胃阴亏虚证3种证型,并运用现代医学阐述三型病机的本质:胃镜下辨证气血亏损者胃黏膜常菲薄伴白相,热毒内蕴者胃黏膜常充血、糜烂,脾虚湿盛者胃黏膜水肿著,血瘀者脉络色紫、胃黏膜粗糙、呈颗粒状或结节状改变。笔者在三型辨证、胃镜下辨证基础上结合专病专药论治CAG取得了好的疗效。

Currently, the syndrome differentiation method for the chronic atrophic gastritis(CAG) has some disadvantages, such as the complicated syndrome differentiation types and lack of gastroscope observation. So, in this article, we simplified the complicated syndrome differentiation types into the 3 main syndrome types, including syndrome of qi(yang) deficiency of spleen and stomach,syndrome of liver depression and qi stagnation or syndrome of incoordination between liver and stomach, and syndrome of yin deficiency of stomach, and elucidated the essence of the pathogenesis of the 3 main syndrome types using the gastroscope observation, with syndrome differentiation under gastroscopy, the qi and blood deficiency is often with gastric mucosa thin and white, the accumulation of heat and toxic is often with congested erosion of gastric mucosa, the spleen deficiency and damp hyperactivity is often with significant edema of gastric mucosa, the blood stasis is often with purple vein, granular or nodular change of rough gastric mucosa; the three syndrome types combined with syndrome differentiation under gastroscopy, the special drugs for the treatment of CAG achieved a good curative effect.