基于“以通为补”思想结合疮疡理论治疗慢性胃炎经验

Experience in treating chronic gastritis based on the idea of ‘obstruction-removing as tonifying therapy’ and sore theory

慢性胃炎是一种以慢性胃黏膜炎性病变为特征的消化系统疾病,临床表现为上腹隐痛、食欲减退、腹胀、反酸等。外感六淫或内生五邪致使脾胃运化失职,气机升降失衡,清阳不升,浊阴不降,积湿而不化浊,气郁而不布津,血不养经,胃体失于濡养,日久“毒邪”积聚,导致胃炎发生。主要病位在胃,与脾、肝、肾密切相关。秦国政教授认为,即使胃腑受邪,也不可过用“通”法,以免耗伤正气,应遵循“以通为补”思想,结合外科疮疡理论,确立本病治法为温中托毒、益气托毒、清热养阴托毒、清消托毒,四君子汤、平胃散、玉女煎、三仁汤等为其常用方剂,同时加入治疗“内痈”常用药蒲公英、白芷、黄芪等,随症加减变化,临床疗效显著。

Chronic gastritis is a digestive system disease characterized by chronic inflammatory lesions of the gastric mucosa.It’s clinical manifestations are dull pain in the upper abdomen,loss of appetite,abdominal distention,acid reflux,and so on.Exogenous six climatic exopathogens or endogenous five pathogenic factors lead to the failure of ascending and descending of spleen and stomach,imbalance of qi movement,no rise of qingyang,no fall of turbid yin,accumulation of moisture without dissipation of turbidness,qi stagnation without dispersing fluid,blood does not nourish the meridians and the stomach loses nourishment,and the accumulation of toxin over time leading to the occurrence of gastritis.The main disease location is the stomach,closely related to the spleen,liver and kidney.Professor QIN Guo-zheng believes that even if the stomach is affected by toxins,the ‘tong’ method should not be overused,so as not to damage the healthy qi,and it should follow the idea of ‘tong as the tonic’,combined with the theory of surgical sore.The treatment of the disease was established and it included warming and tonifying to eliminate toxins,nourishing qi to eliminate toxins,clearing heat and nourishing yin to eliminate toxins,clearing and eliminating to eliminate toxins.Sijunzi Decoction,Pingwei Powder,Yunv Decoction,Sanren Decoction are common prescription,while adding the common medicine of ‘internal welling-abscess’,such as Taraxaci Herba,Angelicae Dahuricae Radix,Astragali Radix,with the changes of symptoms to add or subtract drugs,and the clinical effect is significant.