慢性胃炎在临床中十分常见,该疾病的发病原因并不单一,而治疗慢性胃炎的方法很多,中西医结合治疗的效果更佳。邓国鹏为安顺市中医医院副主任医师,从事中医临床、科研、教学工作20余年,有着丰富的临床经验,提倡五行辨证学术思想,对慢性胃炎的诊疗有独到的见解,主张遵循“脾以守为补,胃以通为补,肝以散为补”的原则治疗慢性胃炎。笔者有幸跟师于邓老,本文基于邓老学术思想将理论和验案相结合,归纳邓老慢性胃炎的辨治思路与用药特点,为临床中医药防治疾病提供参考。Chronic gastritis is very common in clinical practice. The etiology of this disease is not singular. There are many methods to treat chronic gastritis, and the combination of traditional Chinese medicine and Western medicine has proven to be more effective. Guopeng Deng is a deputy chief physician at Anshun Traditional Chinese Medicine Hospital. With over 20 years of experience in clinical practice, research, and teaching in traditional Chinese medicine, he has rich clinical experience. He advocates five elements of academic thought and has unique insights into the diagnosis and treatment of chronic gastritis. He insists on treating chronic gastritis according to the “spleen to keep for fill, stomach to fill, liver to scattered for” the principle of treatment of chronic gastritis. The author had the honor to learn from Deng Lao. Based on Deng’s academic thoughts, this paper this article combines theory with clinical cases to summarize his diagnostic and treatment approach and medication characteristics for chronic gastritis, providing a reference for the clinical prevention and treatment of diseases using traditional Chinese.
目的:总结腹泻型肠易激综合征的中医药治疗研究进展。方法:从病因病 机、辨证分型、中药内服法、中医外治法、基础试验研究等5个方面来总结近年来中医药治疗腹泻型肠易激综合征的临床研究进展,同时指出研究中存在的问题。结果与结论:中医药治疗腹泻型肠易激综合征有明显的优势,值得推广应用。Objective: To summarize the progress of TCM treatment of diarrhea type irritable bowel syndrome. Methods: The clinical research progress of TCM treatment in recent years was summarized from the five aspects of etiology, syndrome differentiation, TCM internal administration, TCM external treatment, and basic experiment, and pointed out the problems existing in the research. Results and Conclusion: Traditional Chinese medicine has obvious advantages in treating diarrhea type IBS, which is worth popularization and application.
慢性萎缩性胃炎(chronic atrophic gastritis, CAG)是慢性胃炎的一种类型,系指胃黏膜上皮遭受反复损害导致固有腺体的减少,伴或不伴肠腺化生和(或)假幽门腺化生的一种慢性胃部疾病。大多数该病患者无特异性临床表现,多因中上腹部不适、餐后饱胀、口苦、烧心、泛酸等症就诊,行胃镜、病理检查后方才确诊。世界卫生组织(WHO)早在多年前就指出了CAG属于胃癌的癌前状态,其中若是伴有肠化或不典型增生,癌变风险则会进一步增加。相关研究表明国外CAG的癌变率为8.6%~13.8%,而我国CAG的癌变率为1.2%~7.1%。不同地域饮食结构及生活习惯各有不同,饮食偏嗜、喜好烟酒浓茶、熬夜、各方面压力等均可导致胃肠疾病的发生发展,目前CAG的检出率也呈现逐渐上升趋势,而CAG作为胃癌的癌前状态,不得不引起我们的注意。CAG患者多为老年人,近50%胃黏膜存在萎缩改变的为50岁以上老年人,70%在40岁以上。国外研究发现,如南美、东亚、东欧等胃癌高发地,CAG的检出率也是居高不下的。荷兰通过10年对92,250例胃癌前病变患者进行随访发现肠化和萎缩性胃炎的胃癌发生率0.25/年和0.1%/年。国内研究调查发现,CAG患者主要集中于广西、福建、黑龙江等地,该病检出率约占胃镜检查的7.5%~13.8%。青海省人民医院消化内科通过研究本院187例胃镜检查报告显示:青海地区CAG发生率显著高于平原地区,胃镜室所检病种中CAG构成比高达72.47%,CAG发病率随年龄增长而增加。故探讨慢性萎缩性胃炎的研究进展至关重要,本文从中西医结合的角度论述慢性萎缩性胃炎的研究进展,为临床科研提供相应的帮助。Chronic atrophic gastritis (chronic atrophic gastritis, CAG) is a type of chronic gastritis, which refers to a chronic gastric disease leading to the reduction of native glands, with or without intestinal metaplasia and (or) pseudopyloric metaplasia. Most of the patients with this disease do not have specific clinical manifestations, and are usually due to middle and upper abdominal discomfort, postprandial fullness, bitter mouth, heartburn, pantothenic acid and other diseases, which are confirmed after gastroscopy and pathological examination. The World Health Organization (WHO) pointed out that CAG is a precancerous state of gastric cancer many years ago, where the risk of cancer is accompanied by enterization or atypical hyperplasia. Related studies show that the cancer rate of CAG abroad is 8.6%~13.8%, while the cancer rate of CAG in China is 1.2%~7.1%. Different regions have different dietary structure and living habits, including preference for eating, tobacco, alcohol and tea, staying up late, and all aspects of pressure can lead to the occurrence and development of gastrointestinal diseases. At present, the detection rate of CAG is also gradually rising trend, and CAG, as a precancerous state of gastric cancer, has to attract our attention. Most of the CAG patients are
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