任顺平教授从“虚瘀、逆、毒”论治慢性萎缩性胃炎

Treating chronic atrophic gastritis from the perspectives of deficiency,blood stasis,reversion and toxicity by Professor REN Shunping

萎缩性胃炎又称慢性萎缩性胃炎,是一种由多致病因素引起的消化系统慢性疾病。长期的慢性炎症刺激引起胃黏膜固有腺体萎缩,导致胃分泌胃液及胃蛋白酶的能力降低,影响了胃部的正常生理功能,主要病理表现为胃黏膜遭受各种因素的损坏后固有腺体呈萎缩性改变或减少,可伴有肠上皮化生、异型增生等病理改变。早期萎缩性胃炎无明显特异性表现,可出现不同程度的胃部胀满、胀痛等消化不良相关症状,若未及时治疗会并发胃出血、胃溃疡以及癌前病变等。因此,有效干预慢性萎缩性胃炎、控制甚或逆转癌前病变的进展对胃癌的早期预防具有重要意义。中医药在治疗慢性萎缩性胃炎及逆转癌前病变等方面具有独特的优势。山西中医药大学附属医院任顺平教授从事中西医结合诊治消化系统疾病工作30余年,对慢性萎缩性胃炎及伴肠上皮化生、异型增生等有自己的独特见解。基于多年的临床经验,任顺平教授认为慢性萎缩性胃炎以“虚”为本,“瘀”为标,而肠上皮化生为“逆”,异型增生为“毒”。治疗方面,任教授以健脾益气化瘀为基本原则,结合病理检查结果加以疏木通腑、清热解毒,临床疗效显著。文章结合案例介绍任教授治疗慢性萎缩性胃炎的经验,以期为临床提供参考。

Atrophic gastritis,also known as chronic atrophic gastritis,is a chronic disease of digestive system caused by multiple pathogenic factors.Long-term chronic inflammatory stimulation causes atrophy of the gastric mucosa intrinsic glands atrophy,which reduces the ability of the stomach to secrete gastric fluid and pepsin,and affects the normal physiological function of the stomach.The main pathological manifestations are atrophic changes or reduction of the proper glands after gastric mucosa damage caused by various factors,which may be accompanied by intestinal metaplasia,dysplasia and other pathological changes.Early atrophic gastritis has no obvious specific performance.The patients may have dyspepsia related symptoms such as gastric distension and pain to varying degrees.If it is not treated in time,gastric bleeding,gastric ulcer and precancerous lesions may occur.Therefore,it is of great significance for the early prevention of gastric cancer to effectively intervene in chronic atrophic gastritis,and control or even reverse the progress of precancerous lesions.TCM has unique advantages in treating chronic atrophic gastritis and reversing precancerous lesions.Professor REN Shunping,from the Affiliated Hospital of Shanxi University of Traditional Chinese Medicine,has been engaged in the diagnosis and treatment of digestive system diseases in the integrative medicine for more than 30 years,and has his own unique views on chronic atrophic gastritis,intestinal metaplasia,dysplasia,etc..Based on many years of clinical experience,Professor REN Shunping believes that chronic atrophic gastritis is based on deficiency and marked by blood stasis,while intestinal metaplasia as inverse,dysplasia as toxic.In terms of treatment of the disease,Professor REN Shunping takes invigorating the spleen,replenishing Qi(气)and removing blood stasis as the basic principle,combined with pathological examination results to dredge the liver,clear away heat and detoxify.The clinical effect is significant.In this paper,Professor REN’s experience in treating chronic atrophic gastritis is introduced with a case analysis in order to provide a reference for clinical practice.