陈卫建治疗慢性萎缩性胃炎伴肠化生经验介绍

Experience Introduction of CHEN Weijian in Treating Chronic Atrophic Gastritis with Intestinal Metaplasia

介绍陈卫建教授治疗慢性萎缩性胃炎伴肠化生的临床经验。陈教授认为,在病因病机上,慢性萎缩性胃炎伴肠化生,以脾胃虚弱为发病根本;久处湿地,饮食不节,易湿邪致病;肝气犯脾胃,气机升降失常;气血瘀滞贯穿整个过程。在治法上,当注重补虚培土,从补着手;注重气机通畅,以通为用;注重健脾祛湿,从湿而治;注重活血化瘀,从瘀而治。临证四诊合参,并通过胃镜和病理活检提示的胃黏膜萎缩性程度和肠化程度以指导疾病的治疗,创拟七白粉以改善瘀血,三草调胃汤以逆转肠化生。

This paper introduces Prof.CHEN’s clinical experience in treating chronic atrophic gastritis with intestinal metaplasia.Prof.CHEN believes that,in terms of etiology and pathogenesis,chronic atrophic gastritis with intestinal metaplasia is fundamentally caused by the weakness of the spleen and stomach.Patients who live in a damp environment and have improper diet will catch the disease easily due to pathogenic dampness;the liver qi invades the spleen and stomach,resulting in abnormal qi movement;blood stasis exists during the whole process.In terms of treatment,we should start from supplementation,and pay attention to supplement deficiency and bank up earth;we should stress on unblocking,and pay attention to freeing the qi movement;we should treat the disease from dampness and emphasize on fortifying the spleen and removing dampness;we should treat the disease from stasis and pay attention to invigorating blood and dissolving stasis.In clinical differentiation,the four diagnoses should be referred to together,and the degree of gastric mucosa atrophic and intestinal metaplasia indicated by gastroscopy and pathological biopsy should be used to guide the treatment of the disease.The prescriptions can be self-made Qibai powder,which is to improve blood stasis,and Sancao Tiaowei tang,which is to reverse intestinal metaplasia.