| 叶林茂,黄瑶,王蔚玲,等.“一气周流”视角下慢性萎缩性胃炎伴肠化的辨治思路[J].浙江中医药大学学报,2022,46(12):1332-1335, 1346. |
| “一气周流”视角下慢性萎缩性胃炎伴肠化的辨治思路 |
| Differentiation and Treatment of Chronic Atrophic Gastritis with Intestinal Metaplasia from the Perspective of “Circular Flow of Qi” |
| DOI：10.16466/j.issn1005-5509.2022.12.005 |
| 中文关键词: 慢性萎缩性胃炎 “一气周流”理论 辨治思路 中土虚衰 健脾胜湿 清肺降胃 温肾和胃 疏肝清心 |
| 英文关键词: chronic atrophic gastritis the theory of “circular flow of Qi” differentiation and treatment ideas spleen-stomach weakness strengthening the spleen and overcoming dampness clearing the lung and harmonizing the stomach warming the kidney and harmonizing the stomach soothing the liver and clearing the heart |
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| 中文摘要: |
| [目的] 基于“一气周流”理论，探索慢性萎缩性胃炎伴肠化的辨治新思路。 [方法] 通过总结临床经验，阅读清代医家黄元御的《四圣心源》，归纳慢性萎缩性胃炎伴肠化的辨治思路，并附验案一则。[结果] 黄元御“一气周流”理论认为，人体内有一股无形之气周转不息，其基本运动方式为“左路木火升发，右路金水敛降，中焦土气斡旋”。该理论视角下，慢性萎缩性胃炎伴肠化核心的病机为中土虚衰，“四象轮旋”不畅而生气滞、痰凝、血瘀是推动本病发展的重要因素。在此基础上，提出健脾胜湿、清肺降胃、温肾和胃、疏肝清心等辨治本病的新思路。验案所举之患者，年老而病长，阳衰而土湿，“一气周流”不畅，证属湿热内蕴、痰瘀互结，故予上述四法治之，复查胃镜肠化得以减轻。[结论] 以“一气周流”理论为切入点，以调和五脏、促气流转为纲，拓宽了本病的临床诊治思路。 |
| 英文摘要: |
| [Objective] To explore a new idea of syndrome differentiation and treatment of chronic atrophic gastritis with intestinal metaplasia based on the theory of “circular flow of Qi”. [Methods] Through summarizing clinical experience， reading the Sisheng Xinyuan written by HUANG Yuanyu， a doctor in the Qing Dynasty， this paper summarized the ideas of syndrome differentiation and treatment of chronic atrophic gastritis with intestinal metaplasia， and attached an experimental case. [Results] According to the theory of “circular flow of Qi” put forward by HUANG Yuanyu， there is an invisible Qi circulating in the human body， and its basic movement mode is “wood and fire ascend and dredge on the left， metal and water descend and astringe on the right， while earth mediates in middle-Jiao”. From the perspective of this theory， the core pathogenesis of chronic atrophic gastritis with intestinal metaplasia is spleen-stomach weakness. Qi stagnation， phlegm coagulation and blood stasis caused by the sluggish rotation of “the other four internal organs‘ function” are important factors to promote the development of the disease. Then it puts forward new ideas of syndrome differentiation and treatment， such as strengthening the spleen and overcoming dampness， clearing the lung and harmonizing the stomach， warming the kidney and harmonizing the stomach， soothing the liver and clearing the heart. The patient mentioned in the case was old and ill for a long time， Yang was deficient and earth was damp， and the “circular flow of Qi” was not smooth. The syndrome was the accumulation of dampness and heat， and the interjunction of phlegm coagulation and blood stasis. Therefore， the above four methods were applied， and gastroscope indicated that the intestinal metaplasia had been alleviated. [Conclusion] Taking the theory of “circular flow of Qi” as the starting point and harmonizing the five viscera and promoting the circulation of Qi as the key link broadens the clinical diagnosis and treatment of the disease. |
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