王小奇论治慢性萎缩性胃炎的用药规律浅析

华鑫; 张楚楚; 蒋廷; 谢菲菲; 钱素婷; 刘庆生

doi:10.3969/j.issn.1671-038X.2024.03.13

王小奇论治慢性萎缩性胃炎的用药规律浅析

- 浙江中医药大学附属杭州市中医院消化科(杭州，310007)
基金项目:
浙江省中医药科技计划项目(No：2023ZL091)；杭州市医药卫生重点计划项目(No：ZD20210047)

详细信息

通讯作者: 刘庆生，E-mail：7394822@qq.com

中图分类号: R573.32

收稿日期: 2023-04-12

刊出日期: 2024-03-15

Analysis of WANG Xiaoqi's medication rules in the treatment of chronic atrophic gastritis

- Department of Gastroenterology, Hangzhou Traditional Chinese Medicine Hospital Affiliated to Zhejiang Chinese Medicine University, Hangzhou, 310007, China

More Information

Corresponding author: LIU Qingsheng, E-mail: 7394822@qq.com

Received Date: 12 April 2023

Publish Date: 15 March 2024

摘要

摘要: 王小奇主任工作四十余载，在多年的临床实践中逐渐形成了独特的辨证用药理论体系，在慢性萎缩性胃炎的诊治中别具一格。王小奇主任认为慢性萎缩性胃炎基本病机无非肝郁气滞，脾胃虚弱，湿、瘀、毒等病理因素相伴随，因此在治疗时围绕肝脾论治，精准选用药对，标本兼治。此外，王小奇主任讲究辨证与辨病相结合，对于萎缩与肠上皮化生等不同的病理结果，有独到的用药心得，可以有效延缓甚至逆转胃癌前病变的发生、发展，值得临床推广。
- 慢性萎缩性胃炎 /
- 肠上皮化生 /
- 用药规律
Abstract: Director WANG Xiaoqi has been working for more than 40 years and has gradually formed a unique theoretical system of dialectical medication through years of clinical practice, which is unique in the diagnosis and treatment of chronic atrophic gastritis. Director WANG Xiaoqi believes that the basic pathogenesis of chronic atrophic gastritis is nothing more than stagnation of Qi due to depression of the liver, weakness of the spleen and the stomach, accompanied by pathological factors such as dampness, blood stasis, and poison. Therefore, in the treatment, the focus is on the liver and spleen, precise selection of medication pairs, and mutual consideration of symptoms and root cause. In addition, Director WANG Xiaoqi emphasizes the combination of syndrome differentiation and disease differentiation. He has unique medication experience for different pathological results such as atrophy and intestinal metaplasia, which can effectively delay or even reverse the occurrence and development of gastric precancerous lesions, and is worthy of clinical promotion.
- chronic atrophic gastritis /
- intestinal metaplasia /
- medication rules

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参考文献(23)

[1]	Pimentel-Nunes P, Libanio D, Marcos-Pinto R, et al. Management of epithelial precancerous conditions and lesions in the stomach(MAPS Ⅱ): European Society of Gastrointestinal Endoscopy(ESGE), European Helicobacter and Microbiota Study Group(EHMSG), European Society of Pathology(ESP), and Sociedade Portuguesa de Endoscopia Digestiva(SPED)guideline update 2019[J]. Endoscopy, 2019, 51(4): 365-388. doi: 10.1055/a-0859-1883
[2]	Aumpan N, Vilaichone RK, Pornthisarn B, et al. Predictors for regression and progression of intestinal metaplasia(IM): a large population-based study from low prevalence area of gastric cancer(IM-predictor trial)[J]. PLoS One, 2021, 16(8): e0255601. doi: 10.1371/journal.pone.0255601
[3]	Hwang YJ, Choi Y, Kim N, et al. The difference of endoscopic and histologic improvements of atrophic gastritis and intestinal Metaplasia after Helicobacter pylori eradication[J]. Dig Dis Sci, 2022, 67(7): 3055-3066. doi: 10.1007/s10620-021-07146-4
[4]	Guo Y, Zhang Y, Gerhard M, et al. Effect of Helicobacter pylori on gastrointestinal microbiota: a population-based study in Linqu, a high-risk area of gastric cancer[J]. Gut, 2020, 69(9): 1598-1607. doi: 10.1136/gutjnl-2019-319696
[5]	Xia CF, Dong XS, Li H, et al. Cancer statistics in China and United States, 2022: profiles, trends, and determinants[J]. Chin Med J (Engl), 2022, 135(5): 584-590. doi: 10.1097/CM9.0000000000002108
[6]	罗业浩, 许栋涵, 黄安, 等. 中医药治疗胃癌的临床研究进展[J]. 中华中医药学刊, 2023, 41(7): 145-151. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS202307030.htm
[7]	董奇灵, 赵慧慧, 李雪莹, 等. 中医药抗幽门螺杆菌感染的研究进展[J]. 中医药学报, 2023, 51(4): 108-111. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXB202304021.htm
[8]	魏玮, 杨洋. 慢性萎缩性胃炎诊治现状及中医药治疗优势[J]. 中医杂志, 2016, 57(1): 36-40. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201601015.htm
[9]	李军祥, 陈誩, 吕宾, 等. 慢性萎缩性胃炎中西医结合诊疗共识意见(2017年)[J]. 中国中西医结合消化杂志, 2018, 26(2): 121-131. https://zxyxh.whuhzzs.com/article/doi/10.3969/j.issn.1671-038X.2018.01.01
[10]	毛若楠, 王石红, 郭爽. 运用中医辨证思维治疗逆转肠上皮化生[J]. 河北中医药学报, 2018, 33(6): 30-32. https://www.cnki.com.cn/Article/CJFDTOTAL-HZYX201806010.htm
[11]	张泰, 张北华, 马祥雪, 等. 慢性萎缩性胃炎炎-癌转化中医病机探析[J]. 中华中医药杂志, 2022, 37(11): 6414-6417. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202211040.htm
[12]	李佃贵, 李海滨, 裴林, 等. 慢性萎缩性胃炎从浊毒论治[J]. 四川中医, 2004, 22(1): 17-18. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY200401009.htm
[13]	陈静, 徐蕾, 曹正民, 等. 姚乃礼教授从"肝郁脾虚, 络阻毒损"论治慢性萎缩性胃炎经验[J]. 天津中医药大学学报, 2022, 41(3): 295-299. https://www.cnki.com.cn/Article/CJFDTOTAL-TZYY202203024.htm
[14]	魏一苇, 文乐兮, 尤昭玲, 等. 尤昭玲教授对佛手的认识与临床应用经验[J]. 湖南中医药大学学报, 2020, 40(11): 1327-1330. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZX202011006.htm
[15]	杜芳, 鱼麦侠, 胡博帆, 等. 三棱-莪术药对抗肿瘤临床应用及作用机制研究进展[J]. 中国医药导报, 2023, 20(2): 39-42. https://www.cnki.com.cn/Article/CJFDTOTAL-YYCY202302008.htm
[16]	杜光华, 刘晓红. 虫类药物临证治验举隅[J]. 中国民族民间医药, 2015, 24(16): 46-47. https://www.cnki.com.cn/Article/CJFDTOTAL-MZMJ201516023.htm
[17]	郝旭蕊, 李娜, 白海燕, 等. 国医大师李佃贵运用虫类药治疗慢性萎缩性胃炎伴肠上皮化生经验[J]. 中华中医药杂志, 2020, 35(3): 1236-1239. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202003048.htm
[18]	王延丽, 朱西杰, 肖清燕. "解毒排毒"治疗胃癌前病变的新思路[J]. 江苏中医药, 2014, 46(1): 5-7. https://www.cnki.com.cn/Article/CJFDTOTAL-JSZY201401003.htm
[19]	邬世威, 陈锦芳, 胡兵. 藤梨根抗癌成分及其作用机制[J]. 中华中医药学刊, 2023, 41(5): 160-163. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS202305035.htm
[20]	Hu C, Zu D, Xu JL, et al. Polyphyllin B suppresses gastric tumor growth by modulating iron metabolism and inducing ferroptosis[J]. Int J Biol Sci, 2023, 19(4): 1063-1079.
[21]	邓芙蓉, 王翰林, 谢佩佩, 等. 绞股蓝皂苷对人胃癌细胞增殖和凋亡的影响及作用机制[J]. 中国药理学通报, 2023, 39(4): 646-652. https://www.cnki.com.cn/Article/CJFDTOTAL-YAOL202304009.htm
[22]	Chen HN, Wang Z, Li X, et al. Helicobacter pylori eradication cannot reduce the risk of gastric cancer in patients with intestinal metaplasia and dysplasia: evidence from a meta-analysis[J]. Gastric Cancer, 2016, 19(1): 166-175.
[23]	陆红, 刘文忠. 努力提高幽门螺杆菌根除率[J]. 胃肠病学, 2020, 25(5): 266-270. https://www.cnki.com.cn/Article/CJFDTOTAL-WIEC202005004.htm