论《黄帝内经》痿证指导慢性萎缩性胃炎辨治思路

Discussion on the thought of syndrome differentiation of flaccid syndrome in Internal Classic guiding the treatment of chronic atrophic gastritis

关键词:  痿证  治痿独取阳明  慢性萎缩性胃炎  病因病机  治则治法

Key words:  take yangming channel exclusively for flaccidity treatment  chronic atrophic gastritis  etiology and pathology  principals and methods of treatment

摘要:

痿证首见于《黄帝内经》，文章通过对《素问·痿论》篇的研读感悟，加之对慢性萎缩性胃炎现代文献研究及对患者的临床观察，认为痿证与慢性萎缩性胃炎（CAG）之“萎”在病因病机上高度一致，均有情志内伤、湿伤脾胃、劳伤耗津及外感热邪等内外之因，并有阳明脾胃虚弱为本，湿热、瘀阻胃络为标的共同病机。故以比类之法，异病同治，将《黄帝内经》中提出的“治痿独取阳明”和“各补其荥而通其俞，调其虚实，和其逆顺”的治痿原则，发挥运用于CAG的临床治疗。以扶正固本、重视升降、通调胃络、辨证论治的思路贯穿于临床治疗之中，收获良效。

Abstract:

The flaccid syndrome first appeared in Internal classic. After reading Plain questions·flaccidity, researching on modern documents on chronic atrophic gastritis (CAG) and observing clinical effect on patients,it can be deduced that the pathogenesis of flaccidity and CAG are highly consistent-they share the same internal and external pathogens such as internal damage by excessive emotions,stomach and spleen damage by excessive dampness,fluid consumption by overstrain,and external heat,etc. They share the yangming stomach-spleen weakness as primary pathology and dampness heat and static blood blocking luo channel of stomach as auxiliary pathology. Therefore,by image comparison,different diseases can be treated with the same method-the Internal Classic treatment principals "take yangming channel exclusively for flaccidity treatment" and "supply and regulate ying point and shu point to mediate deficiency and excess,sequence and reversal" are applied to the clinical treatment of CAG. With the treatment thought of strengthening and consolidating energy,emphasizing ascending and descending, dredging and regulating luo channel of stomach,and syndrome differentiation and treatment running through clinical treatment,good effects are acquired.