“塞因塞用”法治疗脾胃虚弱型原发性胆汁反流性胃炎

Treatment of primary bile reflux gastritis with deficiency of spleen and stomach by“obstruction treated with tonification”method

原发性胆汁反流性胃炎因病因和发病机制尚未完全透彻,临床治疗上难以彻底根治,而长期的胆汁刺激、炎症反复,容易导致胃黏膜发生萎缩、肠上皮化生、不典型增生及癌变等,严重影响人类的生存及生活质量。诸多医家对该病的诊治,多集中在肝胃不和、肝胃郁热、脾胃湿热、寒热错杂等实证证型上,而鲜少有健脾和胃法治疗原发性胆汁反流性胃炎的论述。分析该类患者的发病机制,认为脾胃虚弱为其发病之本,气机升降失调为其发病之机,从“塞因塞用”的反治法入手,运用健脾和胃的治则,选用香砂六君子汤加减,以补开塞,临床疗效确切。

The cause and mechanism of primary bile reflux gastritis are not completely thorough,it is difficult to be cured completely in clinical treatment.In addition,the long-term bile stimulation and the repeated inflammation easily lead to atrophy of gastric mucosa,intestinal metaplasia,atypical hyperplasia and carceration,which seriously affects human survival and quality of life.Many doctors diagnose and treat the disease,mostly focusing on empirical types such as the disharmony between liver and stomach,the depression-heat of liver and stomach,the damp-heat of spleen and stomach and the cold-heat complex.However,there are few discussions on the treatment of primary bile reflux gastritis by invigorating spleen and stomach.The author of this article believes that the weakness of spleen and stomach is the root of the disease and the imbalance of qi rise and fall is the pathogenesis of the disease.On the basis of the contrary treatment method of“obstruction treated with tonification”and the principle of invigorating spleen and stomach,the Xiangsha Liujunzi Decoction is used.It is revealed that the clinical effect is accurate with the supplement of the opening plug.