慢性萎缩性胃炎中医“虚证”证候的辨治思路

Thoughts on Differential Diagnosis and Treatment of Deficiency Syndrome of Chronic Atrophic Gastritis in Traditional Chinese Medicine

慢性萎缩性胃炎(chronic atrophic gastritis,CAG)是临床常见病,多见虚证或虚实夹杂证。中医辨证论治对CAG的临床诊治具有十分重要的意义,但现阶段缺乏系统的针对CAG“虚证”的辨治体系,文章以“虚证”为着力点,指出纲领性的证病结合的辨证思路。结合内镜技术,简述了内镜及病理检查下CAG“虚证”的微观表现,并阐释了微观视野下胃黏膜不同表征所体现的辨证意义。治疗上,指出须从气、阴、阳虚论治,并重视先、后天的作用,通过补益脾肾达到更好的治疗效果,据此为临床多角度、多层次辨治CAG“虚证”提供治疗思路。

Chronic atrophic gastritis(CAG)is a common clinical disease,it is common to see deficiency syndrome or mixed syndrome of deficiency and excess.Syndrome differentiation and treatment has great significance to the clinical diagnosis and treatment of CAG,but there is no systematic diagnosis and treatment system for CAG“deficiency syndrome”at the present stage.Taking“deficiency syndrome”as the focal point,this paper points out the programmatic syndrome differentiation idea of the combination of syndrome and disease.Combined with endoscopic technology,this paper briefly describes the microscopic manifestations of CAG“deficiency syndrome”under endoscopy and pathological examination,and explains the syndrome differentiation significance of different representations of gastric mucosa in microscopic vision.In terms of treatment,it is pointed out that it is necessary to treat deficiency of Qi and Yin,and pay attention to the role of antecedent and acquired,so as to achieve a better therapeutic effect by tonifying the spleen and kidney,from this to provide treatment ideas for clinical multi-angle and multi-level differentiation and treatment of chronic atrophic gastritis“deficiency syndrome”.