张杰教授辨治慢性萎缩性胃炎特色探析

Analysis of Professor ZHANG Jie's Characteristics in Treating Chronic Atrophic Gastritis

[目的]总结国家级名老中医张杰教授辨治慢性萎缩性胃炎的经验。[方法]通过临床跟师、收集病例,对张杰教授治疗慢性萎缩性胃炎的中医理论创新及临床思路进行分析总结,并列举医案验证。[结果]在慢性萎缩性胃炎诊治方面,张教授认为脾胃亏虚为本,内外合毒为因,胃络瘀阻为标,虚、毒、瘀互结,并独创“肝脾建中、脾阳为本”理论指导临床,主张以肝脾同建、顾护脾阳为主要治法,兼顾解毒化瘀、扶助正气,临证重视舌脉合参,遣方用药遵循经方。所附医案,张教授辨为肝胃气滞、毒瘀互结,治宜肝脾同建、行气宽中、解毒化瘀,以柴平汤、胃痞汤两方加减治疗,获得良好疗效。[结论]张杰教授治疗慢性萎缩性胃炎,注意肝脾同建、顾护脾阳,兼顾解毒化瘀、扶助正气,临证时重视舌脉,遵循经方,其经验值得临床借鉴学习。

[Objective]To summarize the experience of national traditional Chinese medicine(TCM)expert Professor ZHANG Jie in the treatment of chronic atrophic gastritis(CAG).[Methods]Through clinical follow-up and collection of cases,Professor ZHANG’s theoretical innovation and clinical ideas of TCM in the treatment of CAG were analyzed and summarized,and one medical record was enumerated for verification.[Results]In the diagnosis and treatment of CAG,Professor ZHANG considers that the desficiency of the spleen and stomach is the foundation,the combination of internal and external toxin is the cause,and stagnation of stomach collateral is the symptoms,and the combination of deficiency,stasis and toxin runs through the whole course of the disease.Professor ZHANG advocates the principle of treating liver and spleen together,protecting the spleen Yang to guide clinical practice,giving consideration to detoxification and blood stasis removing,and vital Qi supporting,attaches importance to the tongue and pulse,and makes prescriptions following the classical prescriptions,which has a significant effect.The medical case was identified as Qi stagnation of liver and stomach,combination of toxin and blood stasis.After treated with modified Chaiping decoction and Weipi decoction according to the rules of strengthening the liver and spleen together,promoting Qi circulation to alleviate middle energizer,detoxification and removing blood stasis,the patient achieved good results.[Conclusion]Professor ZHANG Jie treats CAG according to the principle of treating liver and spleen together,and protecting the spleen Yang,giving consideration to detoxification and blood stasis removing,and vital Qi supporting,attaches importance to the tongue and pulse,and makes prescriptions following the classical prescriptions,his experience is worthy of clinical learning.