周宜轩阴阳分论辨治慢性萎缩性胃炎经验

Zhou Yixuan′ Experience in Treatment Chronic Atrophic Gastritis from Perspective of Yin and Yang

周宜轩教授辨治慢性萎缩性胃炎从阴阳立论,重视脾胃肝肾,强调慢性萎缩性胃炎以阴虚者多,以阳虚者少,而以阳虚为体现者,又多是阴阳两虚。结合脏腑及气血辨证,将脾胃湿热证、肝胃不和证、肝脾不和证归属于阴虚范畴。将脾胃虚寒证、脾肾阳虚证归属于阴阳两虚范畴。由此分别确立"健脾化湿,清热益胃生津""疏肝和胃泻热""疏肝泻热理脾""滋阴兼温补脾胃""滋阴兼温补脾肾"等治疗大法。周教授用药精准,清热益胃生津药多用十大功劳叶、石斛、麦冬、南沙参、北沙参、酒黄精等;疏肝药多用醋香附、郁金等;和胃药多用瓦楞子、代赭石,有胃热瘀血者常配三棱、莪术、川芎、旋覆花等;理脾药多用炒白术、白芍、防风、陈皮等;温补脾胃药多用干姜、高良姜、白豆蔻、砂仁、黄芪等;温补肾阳药多用山萸肉、灵芝、牛膝、补骨脂等。

Professor Zhou Yixuan’s treatment of chronic atrophic gastritis is usually carried out from perspective of Yin and Yang,attaching great importance to the Spleen,Stomach,Liver and Kidney,emphasizing that most of the cases of chronic atrophic gastritis are with Yin deficiency Syndrome,or less are with Yang deficiency. In cases of Yang deficiency,most of them are Yin and Yang deficiency Syndromes. Combined with the diagnosis of Zang and Fu as well as Qi and Blood,the Spleen and Stomach Dampness and Heat Syndrome,Liver and Stomach disharmony Syndrome as well as Liver and Spleen disharmony Syndrome are attributed to the Yin deficiency category. The Spleen and Stomach deficiency and Coldness Syndrome,Spleen and Kidney Yang deficiency Syndrome belong to Yin and Yang deficiency Syndrome category. Therefore,the treatment principles of " tonifying Spleen and dissolving Dampness", " clearing Heat and tonifying Stomach to produce fluid", " soothing Liver Qi,tonifying Stomach and clearing Heat", " soothing Liver Qi,clearing Heat and regulating Spleen", " nourishing Yin and warming Spleen and Stomach" " nourishing Yin and warming Spleen and kidney" are established. Prof. Zhou uses the medicine accurately,medicines functioning in clearing Heat,tonifying Stomach and promoting the fluid are Mahonia fortunei,Dendrobium,Ophiopogon japonicum,Ladybell root,Coastal Glehnia Root,Polygonatum,The liver-dissolving medicine is mostly used with vinegar,turmeric,etc.;and the stomach medicine is mostly made of Concha arcae and ruddle. When the stomach is hot and with blood stasis,rhizoma sparganii,zedoary rhizome,ligusticum chuanxiong,twirling flower are often used;regulating Spleen medicines such as Atractylodes atractylodes,paeony,Saposhnidoviae radix,orange peel are often used. Warming Spleen and Stomach medicines are usually dried ginger,galangal,white bean glutinous,Amomum villosum,Astragalus,etc.;warming Kidney yang medicines are pulp of dogwood fruit,Ganoderma lucidum,Achyranthes,psoralen and so on.