慢性萎缩性胃炎中医病因病机及证候研究进展-中国中医药信息杂志.PDF

2015 年8月第 22卷第8期 中国中医药信息杂志 ·133 · 慢性萎缩性胃炎中医病因病机及证候研究进展 晁俊,刘绍能 中国中医科学院广安门医院消化科,北京 100053 摘要：慢性萎缩性胃炎(CAG)是以胃黏膜固有腺体萎缩、黏膜变薄、黏膜肌层变厚、胃酸分泌减少或伴肠 上皮化生或假幽门腺化生为其病理特点的疾病,中医辨证治疗有明显的优势,笔者通过对有关 CAG 文献的总结, 从病因病机、辨证分型特点及其与胃镜像、病理、幽门螺杆菌感染相关性等方面进行综述,为中医临床提供 参考。 关键词：慢性萎缩性胃炎；病因病机；证候；综述 DOI：10.3969/j.issn.1005-5304.2015.08.041 中图分类号：R259.733.2 文献标识码：A 文章编号：1005-5304(2015)08-0133-04 Research Progress of TCM Etiology, Pathogenesis and Syndromes of Chronic Atrophic Gastrtis CHAO Jun, LIU Shao-neng (Gastroenterology Department, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing 100053, China) Abstract ：Chronic atrophic gastritis (CAG) is the disease with the pathological features of gastric mucosa inherent glands atrophy, mucous membrane thinning, muscularis mucosa thickening, gastric acid secretion decreasing, or along with intestinal metaplasia or pseudopyloric metaplasia. TCM differential treatment has obvious advantages. Through the summary of the literature on CAG, the authors summarize the aspects of etiology and pathogenesis, syndrome differentiation characteristic and their relations with gastroscopic image, pathology, and Helicobacter pylori infection, with a purpose to provide references for TCM clinic. Key words ：chronic atrophic gastritis；etiology and pathogenesis；syndrome；review 慢性萎缩性胃炎(chronic atrophic gastritis, 或肝郁脾虚,运化失常；⑤久病多瘀,胃络不通,失于 CAG)属慢性胃炎中的一种,以胃黏膜固有腺体萎缩、 荣养或肝郁气结,横逆犯胃,气血阻滞,不通则痛；⑥ 黏膜变薄、黏膜肌层变厚、胃酸分泌减少或伴肠上皮 久病气血亏虚,虚热内生,灼热耗津,胃阴不足或久病 化生或假幽门腺化生为其病理特点,临床以上腹部疼 多瘀,瘀久化热或肝气久郁,郁而化火,灼伤胃阴,胃 痛胀满、嗳气、纳呆,日久不愈及消瘦乏力为主要表 络失于润养。刘氏[2]认为,CAG 病因有内因、外因、不 现。重度萎缩性胃炎伴中重度肠上皮化生及重度不典 内外因 3 种,即情志不舒、郁