基于“玄府-气液-胃络”理论论治慢性萎缩性胃炎

Treatment of chronic atrophic gastritis based on the theory of"xuanfuqi-fluids-stomach collaterals"

慢性萎缩性胃炎是临床上的多发病和常见病,根据症状可将其归属于中医学“胃脘痛”“痞满”等范畴,其发病机制与玄府、气液、胃络功能失常密切相关。本文系统梳理玄府、气液、胃络的历史源流及三者之间的关系,根据“玄府-气液-胃络”的结构、生理功能和病理特点,结合慢性萎缩性胃炎的病程演变,认为玄府郁闭是慢性萎缩性胃炎发生的直接原因,气液失宣是慢性萎缩性胃炎进展的中心环节,络虚毒损是慢性萎缩性胃炎进展的根本原因。基于玄府郁闭、气液失宣、络虚毒损病机,提出开通玄府、恢复枢机,活血利水、宣通气液,以补助通、补虚通络的治疗原则。从“玄府-气液-胃络”的角度出发,可以更加系统、全面地了解慢性萎缩性胃炎的动态发展过程,为中医药治疗本病提供新思路。

Chronic atrophic gastritis is a common and frequent disease in clinical practice.The symptoms of this disease can be attributed to the categories of"gastric pain"and"plumpness"in traditional Chinese medicine,and its pathogenesis is closely related to the dysfunction of xuanfu,qi-fluids,and stomach collaterals.In this study,we systematically rationalize the historical origin of the xuanfu,qifluids,and stomach collaterals and the relationship between them.According to the structure,physiological function and pathological characteristics of"xuanfu-qi-fluids-stomach collaterals",combined with the evolution of the chronic atrophic gastritis disease process,xuanfu depression and closure is believed to be the direct cause of chronic atrophic gastritis occurrence.The disharmony between qi and fluids is the core of the progression of chronic atrophic gastritis.Collateral deficiency and toxin damage are the root causes of the progression of chronic atrophic gastritis.Based on the mechanism of"xuanfu depression and closure-the disharmony between qi and fluids-collateral deficiency and toxin damage",it is proposed to open the xuanfu,restore the pivotal mechanism,activate blood circulation and diuresis,propagate qi and fluids,and supplement deficiency to unblock collaterals.From the perspective of"xuanfu-qi-fluids-stomach collaterals",a more systematic and comprehensive understanding of the dynamic development process of chronic atrophic gastritis can be achieved,which will provide new ideas for the treatment of this disease in traditional Chinese medicine.