慢性萎缩性胃炎中医病机分析及方药治疗进展

周荣胜 陈颜

【摘 要】

慢性萎缩性胃炎作为临床中常见的、人群中发病比例逐年增高的消化系统疾病，如何提高本病的诊治效率愈发成为医学界的重要研究课题。关于本病，西医除积极对症处理外，尚未出现有力治疗方案，而以辨证论治为基础的中医诊疗方案有着较为突出的优势与可期的发展前景。文章收集近年来对此病病机分析及其中医方药治疗进展相关文献进行总结，为今后临床诊疗本病提供一定参考。

【关键词】 慢性萎缩性胃炎;病机;方药;综述

【中图分类号】R259   【文献标志码】 A    【文章编号】1007-8517（2021）24-0049-04

Progress in TCM Pathogenesis Analysis and Prescription Treatment of Chronic Atrophic Gastritis

ZHOU Ronsheng1 CHEN Yan*

1.Guizhou University of Traditional Chinese Medicine，Guiyang 550000，China;

2. The First Affiliated Hospital of Guizhou University of Traditional Chinese Medicine，Guiyang 550000，China

Abstract：

Chronic atrophic gastritis is a common digestive system disease in clinic and the proportion of people is increasing year by year. How to improve the efficiency of diagnosis and treatment of chronic atrophic gastritis has increasingly become an important research topic in the medical field. With regard to this disease，in addition to active symptomatic treatment，there is no effective treatment plan in western medicine，and the TCM diagnosis and treatment plan based on syndrome differentiation has more outstanding advantages and prospects for development. In recent years，the related pathogenesis analysis of this disease and the progress of traditional Chinese medicine treatment were summarized in order to provide some reference for better diagnosis and treatment of this disease in the future.

Key words：

Chronic Atrophic Gastritis; Pathogenesis; Prescription; Review

慢性萎縮性胃炎（Chronic atrophic gastritis，CAG）是以胃黏膜上皮和腺体萎缩，胃黏膜相对变薄，数目相对减少，胃黏膜基层增厚，或伴肠腺化生和幽门腺化生，或有非典型增生为特征的慢性消化系统疾病[1]。临床症状一般无特异性，常表现为上腹部满闷或隐痛、纳差、嗳气等症状，疾病后期往往出现贫血，且症状的严重程度同内镜或组织学检查无明显相关性，其中伴中重度肠上皮化生和重度不典型增生者，同胃癌发生的相关度较高[2]。中医古籍未载其病名，然观其症，可将之归入“胃脘痛”“痞满”“嘈杂”等范畴。以下从本病中医病因病机、中医方药治疗进展两大方面对此病进行论述。

1 正本探源，从八纲求病机

1.1 中土虚损，运化失司乃起病之本 《脾胃论》有云：“脾胃之气既伤，而诸病之所有生也。”脾胃为后天之本，人体气机升降之枢纽，若脾胃虚弱，一则气血化生无源，二则无力推动气机，CAG的特殊病位，决定了其所受影响亦是深远，中焦虚弱，是CAG形成的最重要病理基础。……