中医药治疗慢性萎缩性胃炎概况

Overview of Traditional Chinese Medicine in Treating Chronic Atrophic Gastritis

中医药治疗慢性萎缩性胃炎应关注以下几点:各医家从自身认识和经验总结用药,在治则治法上不尽相同,多在经方的基础上衍生经验方和自拟方;既往研究往往缺乏大样本微观辨证及相应治疗的随机对照试验,导致结果缺乏说服力和可信度;既往研究中的疗程长短、疗效判定标准不一,疗效的可重复性较差,且远期疗效的观察研究较少;中医药对本病病机、治疗作用机制缺乏深层次的研究,治疗是多靶点、多因素共同作用结果,难以用现代医学解释其治疗作用途径;慢性萎缩性胃炎存在临床表现多样、缺乏典型性、临床症状与萎缩性病变程度不匹配的现象,单纯以传统的宏观辨证不能准确地判断疾病严重程度,缺乏公认的胃镜像中医证候属性概念及简明实用的微观辨证方法,导致微观辨证与临床宏观辨证脱节,缺乏广泛认可且简明实用的微观辨证方法,临床诊疗推广不足。因此,需要与微观辨证相结合,引进现代科学技术,利用胃镜、病理等检查方式,更深入地说明疾病的本质及变化。

Chinese medicine treatment of chronic atrophic gastritis should pay attention to the following points:each doctor’s selfrecognition and experience summarizes the use of drugs,and the treatment is not the same one. Besides,new prescriptions are derived on the basis of the prescription by experience and self-study;There is often a lack of large-scale microscopic syndrome differentiation and randomized controlled trials of corresponding treatments,resulting in a lack of persuasiveness and credibility of results;previous treatments have different lengths of treatment,different criteria for efficacy,poor reproducibility,and long-term efficacy There are few observational studies;There is a lack of in-depth research on the pathogenesis and therapeutic mechanism of the disease in Chinese medicine. Treatment is the result of multiple targets and multiple factors,and it is difficult to explain its therapeutic action path by modern medicine;chronic atrophic gastritis exists. The clinical manifestations are diverse,with a lack of typicality,and the clinical symptoms do not match the degree of atrophic lesions. The traditional macroscopic syndrome differentiation cannot accurately determine the severity of the disease,lack of the recognized concept of TCM syndromes of gastric mirror image and concise and practical microscopic syndrome differentiation. The method leads to the disconnection between microscopic syndrome differentiation and clinical macroscopic syndrome differentiation,lacking widely recognized and concise and practical micro Dialectical method,clinical diagnosis and treatment inadequate promotion. Therefore,it is necessary to combine with microscopic syndrome differentiation,introduce modern science and technology. In addition,gastroscope,pathology and other examination methods should be used to explain the nature and changes of lesions more deeply.