从“阴火理论”探讨肠上皮化生的证治策略

Strategies for the Treatment of Intestinal Epithelial Metaplasia from the “Yin-Fire Theory”

胃黏膜肠上皮化生是指胃黏膜上皮细胞被肠上皮细胞逐步代替的一种病理状态,属于胃癌前病变范畴。“阴火理论”是李东垣提出的核心学说之一,通过研究“阴火理论”,发现肠上皮化生的机制与阴火病机关系密切,认为该病总属本虚标实、虚实夹杂之侯,脾胃气衰、阴火内生、燔灼胃脘是该病发生发展的核心病机,痰浊、瘀血为重要的致病因素。治疗上当结合临床症状,标本兼顾,以补脾益气、清泻阴火为基本治疗原则,佐以活血祛瘀、理气化痰之法,且顾护脾胃气机的升降协调,为中医治疗肠上皮化生提供新的思路方法。

Gastric mucosal intestinal epithelial metaplasia is a pathological state in which gastric mucosal epithelial cells are gradually replaced by intestinal epithelial cells,which belongs to the category of gastric precancerous lesions.“Yin fire theory” is one of the core theories put forward by Li Dongyuan.Through the relevant research of “Yin fire theory”,the paper found that the mechanism of intestinal metaplasia is closely related to the pathogenesis of Yin fire,and believed that the disease is always a syndrome of deficiency of the original,combined deficiency and excess pattern.The spleen and stomach Qi failure,Yin fire endogenous,and burnt burning of the epigastrium are the core pathogenesis of the development of this disease,and phlegm turbidity and blood stasis are the important pathogenic factors.The treatment should be combined with clinical symptoms and specimens,with the basic treatment principles of tonifying the spleen and Qi,clearing Yin fire,and the method of promoting blood circulation and removing blood stasis,regulating Qi and eliminating phlegm,as well as the coordinating of the rise and fall of Qi mechanism to protect the spleen and stomach,providing a new reference direction for the treatment of intestinal dermatitis by traditional Chinese medicine.