摘要
慢性萎缩性胃炎(CAG)是早期胃癌发生的关键阶段,目前西医多以对症治疗,尚无特效药根治和延缓其进展,且病情多易反复。近年来,随着中医药的大力发展,中医药参与治疗CAG凸显出了明显优势,不仅能够改善症状甚至可逆转其病理改变。杨辉副主任基于肝脾同治理论在治疗CAG上疗效显著,杨副主任认为,CAG病机多为肝郁脾虚,瘀毒互结,实为本虚标实,以脾虚为本、肝郁、瘀毒为标。临证主张以“肝脾同治”为治则,创新性地提出治疗CAG应肝脾同治,培本勿忘畅木,木达勿忽补本,治疗过程中二者应当全顾,切不可只抓其一,二者用药依据患者症状着以主辅。临床多以疏肝解郁治其标、健脾益气以治本,化瘀解毒防其变为主要治法,常投以柴胡疏肝散、四君子汤等方为基础方,随症化裁,方求和缓、标本兼治、方效显著。
Chronic atrophic gastritis(CAG)is a critical stage in the development of early gastric cancer.Currently,Western medicine primarily treats symptoms,lacking specific treatments to cure or slow its progression,and the condi-tion is prone to recurrence.In recent years,with the rapid development of Traditional Chinese Medicine(TCM),TCM has demonstrated significant advantages in the treatment of CAG,not only improving symptoms but even reversing pathological changes.Associate Chief Physician Yang Hui,based on the theory of simultaneous treatment of the liver and spleen,has demonstrated remarkable efficacy in the treatment of CAG.He believes that the pathogenesis of CAG is primarily due to liver depression and spleen deficiency,with blood stasis and toxins intertwined,resulting in a combi-nation of underlying deficiency and superficial excess,with spleen deficiency as the underlying cause and liver depres-sion and blood stasis and toxins as the superficial causes.He advocates for the principle of simultaneous treatment of the liver and spleen,innovatively proposing that CAG should be treated with both the liver and spleen,strengthening the underlying cause without neglecting to unblock the wood,and strengthening the wood without neglecting to tonify the underlying cause.Both should be addressed simultaneously during treatment,never focusing on one or the other.Medications for both should be tailored to the patient’s symptoms,with primary and secondary therapies.Clinically,the primary treatment approach is to soothe the liver and relieve depression to treat the symptoms,strengthen the spleen and replenish qi to address the root cause,and resolve blood stasis,detoxify,and prevent further progression.Formulas such as Chaihu Shugan San and Sijunzi Tang are often used as the foundation,with prescriptions tailored to the symp-toms,aiming for a mild and gentle approach,addressing both the symptoms and the root cause,and achieving signifi-cant efficacy.
作者
谷会廷
杨辉
刘丽丽
杜宇辰
GU Huiting;YANG Hui;LIU Lili;DU Yuchen(Anhui University of Chinese Medicine,Anhui Hefei 230031,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China)
出处
《中医药临床杂志》
2025年第10期1969-1972,共4页
Clinical Journal of Traditional Chinese Medicine
基金
安徽省高水平传承人才支持项目(皖卫传[2023]451号)
国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]175号)。
关键词
肝脾同治
慢性萎缩性胃炎
经验
中医治疗
Liver and spleen treatment
Chronic atrophic gastritis(CAG)
Experience
Traditional Chinese medicine treatment
