王孟英伏痰理论探究慢性浅表性胃炎的诊治规律

Research on the Rule of Diagnosis and Treatment of Chronic Superficial Gastritis by Wang Mengying’s Theory of Latent Phlegm

目的探究王孟英应用“伏痰”理论辨治胃脘痛与慢性浅表性胃炎(Chronic superficial gastritits,CSG)临床文献的各自优势。方法通过古代医案质量评价方法,筛选王孟英辨治胃脘痛的高质量医案,与近3年CSG国内代表性学术成果进行对比研究,通过述评的形式进行描述。结果(1)CSG胃痛期属于肝脾不和型用药平和,其中疏肝法为王孟英所不及,但若兼有“伏痰”临证可参见王孟英用药经验。同时提示今后古籍研究须侧重历代名医对肝脾不和型的临证辨治。(2)CSG胃痛期属于湿热壅滞型报道较为丰富,可供选择的药物较多。同时提示此类CSG的研究今后须着眼于药物的有效性分析,以提炼基础方为研究重点。(3)CSG恢复期属于脾胃虚弱型,王孟英偏重于整体调治的特点是当今研究所欠缺的,可直接为临床提供指导。同时表明中医在调治如CSG等慢性病的过程中,有大量有效的经验值得日后深入挖掘。

Objective To explore the advantages of Wang Mengying’s clinical literature in the treatment of epigastralgia and chronic superficial gastritis(CSG).Methods Through the quality evaluation method of ancient medical cases,the high-quality medical cases of Wang Mengying in the treatment of epigastralgia were screened,compared with the domestic representative academic achievements of CSG in recent three years,and described in the form of review.Results(1)the stomach pain stage of CSG belongs to the type of liver spleen disharmony,among which the method of soothing the liver is inferior to that of Wang Mengying.At the same time,it is suggested that the study of ancient books should focus on the clinical syndrome differentiation and treatment of disharmony of liver and spleen by famous doctors of all ages.(2)There are many reports about CSG in the period of stomachache which belongs to dampness and heat stagnation,and there are many drugs to choose.At the same time,it is suggested that the study of CSG should focus on the analysis of drug efficacy in the future,and focus on the extraction of basic formula.(3)The recovery period of CSG belongs to the type of weakness of spleen and stomach.Wang Mengying’s emphasis on the overall treatment is the lack of the current research institute,which can directly provide guidance for clinical practice.At the same time,it shows that a lot of effective experience of traditional Chinese medicine in the treatment of chronic diseases such as CSG is worthy of further exploration in the future.