| 叶王宇,李亚可,张忠绵,等.基于“火郁发之”探析幽门螺杆菌胃炎的辨治思路[J].浙江中医药大学学报,2023,47(4):450-454. |
| 基于“火郁发之”探析幽门螺杆菌胃炎的辨治思路 |
| Exploring the Treatment of Helicobacter Pylori Gastritis Based on the Therapy of“Dispersing Fire Stagnation” |
| DOI：10.16466/j.issn1005-5509.2023.04.021 |
| 中文关键词: 火郁发之 幽门螺杆菌胃炎 病因病机 清透郁热 辨证论治 医案 |
| 英文关键词: dispersing fire stagnation Helicobacter pylori gastritis etiology and pathogenesis dredging stagnant heat syndrome differentiation and treatment medical case |
| 基金项目:国家自然科学基金项目(82074187) |
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| 中文摘要: |
| [目的] 基于“火郁发之”探讨论幽门螺杆菌胃炎的病因病机与辨证施治，为幽门螺杆菌胃炎的治疗拓展思路。[方法] 通过查阅中医古籍文献，结合现代医学相关理论，探讨“火郁”病机在幽门螺杆菌胃炎发病过程中的作用，将“火郁发之”理论作为切入点进行辨证施治，并赋予医案以证其效。[结果] 幽门螺杆菌胃炎以“火郁”为核心病机，邪气积聚化热是疾病发生发展的重要前提，痰浊、湿热、瘀血、癌毒是病机演变过程中的病理产物，正虚邪实是后期胃黏膜发生萎缩和肠化的必要条件。治疗初期强调因势利导，疏导阳明胃腑气机，驱除邪气、透泄郁热；后期虚实夹杂，在清透伏热的基础上佐以扶正，补透结合。所举验案中患者证属肝胃郁热、湿热瘀阻，以理气透热、化湿通络为主要治法，疗效明显。[结论] 从“火郁发之”论治幽门螺杆菌胃炎，紧扣病机，疗效显著，为中医辨治幽门螺杆菌胃炎提供了新思路，具有重要的指导意义。 |
| 英文摘要: |
| [Objective] To explore the etiology and pathogenesis of Helicobacter pylori(Hp) gastritis and traditional Chinese medicine(TCM) syndrome differentiation and treatment based on the therapy of “dispersing fire stagnation”， and expand ideas for the clinical treatment of Hp gastritis. [Methods] By reviewing the pertinent literature and combining with the relevant theoretical understanding of modern medicine， it explores the role of the pathogenesis of “fire stagnation” in the pathogenesis of Hp gastritis， takes the theory of “dispersing fire stagnation” as the starting point of treatment， and attaches a medical case as evidence. [Results] The core pathogenesis of Hp gastritis is “fire stagnation” and the accumulation of evil Qi and production of heat are important prerequisites for the occurrence and development of the disease. Phlegm turbidity， dampness and heat， blood stasis and cancer toxin are pathological products in the process of pathogenesis evolution， and vital Qi deficiency and evil excess are the necessary conditions for gastric mucosa atrophy and intestinal metaplasia in the later stage. In the early stage of treatment， the emphasis is on capitalizing on the trend， dredging Qi movement of Yangming stomach viscera， exorcising evil Qi， and dispersing the stagnated fire； In the late stage， there is a mixture of deficiency and excess， and the treatment is based on the dredging the stagnant heat， accompanied by strengthening vital Qi. In the medical case mentioned， the patient was classified as the syndrome of liver and stomach heat-stagnation， damp-heat stasis obstruction， and the main treatment methods were dispelling Qi stagnation and dredging the stagnant heat， removing dampness and dredging collaterals， and remarkable effects were obtained after treatment. [Conclusion] The treatment of Hp gastritis from “dispersing fire stagnation” is closely related to the pathogenesis， and the curative effect is remarkable， which provides a new idea for TCM treatment of Hp gastritis and has important guiding significance. |
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