Treatment of chronic atrophic gastritis by combination of "Spleen and Stomach Peiyuan" decoction and pills
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摘要: 慢性萎缩性胃炎作为胃癌癌前病变之一，被人们日渐重视。李学军教授从事中医临床及科研30余载，在治疗慢性萎缩性胃炎方面理论知识深厚，临床经验丰富，认为脾胃气阴两虚乃病变之本，夹杂诸邪，瘀血贯穿始终，并继承创新首届全国名中医马骏教授思想，结合自身经验提出了“脾胃培源”治疗大法及创制了脾胃培源丸，汤丸结合，宏观微观相辅，对、角药灵活运用，效果卓著。该文就李学军教授治疗慢性萎缩性胃炎的临证经验做如下总结。Abstract: Chronic atrophic gastritis(CAG), as one of the precancerous lesions of gastric cancer, has been paid more and more attention. Professor LI Xuejun has been engaged in clinical research and research of Traditional Chinese Medicine for more than 30 years, with profound theoretical knowledge and rich clinical experience in the treatment of CAG. He believes that Spleen-Stomach, Qi and Yin deficiency are the root cause of the disease, mixed with various evils and blood stasis throughout the whole time. He inherited and innovative the idea of Professor MA Jun, the first national famous Chinese Medicine doctor, combined with his own experience, proposed the treatment method of "Spleen and Stomach Peiyuan" and created Spleen and Stomach Peiyuan pill and decoction combination. Macro and micro complement, the flexible use of angle medicine, the effect is outstanding.
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表 1 CAG证型、微观表现及宏观施治
证型 微观表现 宏观施治 肝胃气滞证 胃镜下见黏膜红白相间，以红为主，或见黏膜粗糙，甚至花斑样改变，伴或不伴胆汁反流 脾胃培源方加减，重用香附、枳壳、青陈皮等药物以疏肝和胃、行气解郁 湿热蕴结证 胃镜下见黏膜红白相间，以红为主，局部见隆起或平坦、凹陷型糜烂，或见充血、新鲜出血，伴或不伴胆汁反流，热毒炽盛者或可见赤斑 脾胃培源方加减，酌加黄连、黄芩、吴茱萸等药物以清肝和胃，热毒盛者酌加蒲公英、银花、连翘等清热解毒 寒凝血瘀证 胃镜下见黏膜苍、灰白或红白相间，以白为主，黏膜变薄，皱襞变平或消失，或见丝状血管，呈树枝或结节状改变 脾胃培源方加减，酌加桂枝、炮姜、干姜等药物以温阳散寒 痰瘀互结证 胃镜下见黏膜红白相间，以白为主，可见颗粒样、结节状改变，或息肉样隆起，血管纹络见暗红色树枝样，或伴肠上皮化生、不典型增生 脾胃培源方加减，酌加夏枯草、刘寄奴、瓜蒌等药物以化痰散结、破血消癥 气阴两虚证 胃镜下见黏膜粗糙，红白相间，白相凹陷或黏膜变薄，血管显露，或血管结节状改变，甚至呈龟裂样改变，或见黏液分泌量减少，蠕动缓慢 脾胃培源方加减，重用白术、炙黄芪、石斛等药物以益气养阴 
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