朱方石教授病证结合治疗慢性萎缩性胃炎经验拾萃

ZHU Fangshi's Experience of Treating the Chronic Atrophic Gastritis in the Combination of Disease and Syndrome

[目的]总结朱方石教授治疗慢性萎缩胃炎学术观点和临床经验。[方法]通过临床跟师学习,登记典型病例,查阅相关文献,从病因病机、辨证施治等方面论述朱方石教授治疗慢性萎缩性胃炎学术观点及临床经验,对其病证结合、中西互参、身心同治及方药运用特色进行总结,并列举病案以佐证。[结果]朱方石教授通过卫气营血辨证将慢性萎缩性胃炎分为四个阶段(卫分-气分-营分-血分),分别对应其四个病理时期(萎缩-肠上皮化生-低级别上皮内瘤变-高级别上皮内瘤变),做到分期辨病。在此基础上辨证,可分为脾胃虚弱证、胃阴不足证、气虚瘀热证、肝胃不和证四个常见证型,辨证施方,辨病用药,病证结合。另外强调食养结合,身心同治,临床治疗取得满意疗效。[结论]朱方石教授病证结合治疗慢性萎缩性胃炎有良好的临床疗效,其分期辨病,病证结合,辨病用药的学术观点及临床经验值得推广。

[0bjective] To summarize the academic views and clinical experiences of Professor ZHU Fangshi in treating chronic atrophy gastritis. [Methods] Through the study of clinic with the teacher, registration of typical cases, consulting relevant literature, from the aspects of etiology and pathogenesis, such as dialectical treatment from this Professor ZHU Fangshi academic view and clinical experience in treatment of chronic atrophic gastritis, for their disease, combined Chinese and western, each a summary on the characteristics of pathogenesis and formulas of body and mind, and medical record as evidence. [Results] Professor ZHU Fangshi through the wei-qi-ying-blood divides chronic atrophic gastritis into four stages（Wei-Qi-Yin-Blood） corresponding to the four pathological periods（atrophy-intestinal metaplasia-low level intraepithelial neoplasia-high level intraepithelial neoplasia）, stage disease. On the basis of the dialectic, it can be divided into weak spleen and stomach yin deficiency, Qi deficiency and blood stasis heat syndrome, liver stomach with four types often witness, dialectical different diseases for different medication, and combined disease also emphasizes the nourishment, physical and mental treatment, the clinical curative effect is satisfactory.[Conclusion] The treatment of chronic atrophic gastritis combined with disease has good clinical curative effect, the disease by stages, and combined disease and syndrome of medical academic view and clinical experience is worthy of promotion.