基于李杲之“脏气法时”理论探讨慢性萎缩性胃炎的临证思路

关键词：慢性萎缩性胃炎；脏气法时；脾胃虚弱；阴火内生；补脾胃；泻阴火；李杲中图分类号：R259.733 文献标志码：A 文章编号：1007-3213（2025）06-1515-06DOI：10.13359/j.cnki. gzxbtcm.2025.06.032

Exploration on the Clinical Approach to Chronic Atrophic Gastritis Based on Li Gao's Theory of Zangqi Fashi

HU Xinqi'，HAN Yubin²，CHEN Jinfeng²

Clinical Medical School of Guangzhou University of Chinese Medicine，Foshan 528Ooo Guangdong，China; 2.Foshan Hospital of Traditional Chinese Medicine，Foshan 528OOo Guangdong，China）

Abstract：Chronic atrophic gastritis（CAG）is a common clinical digestive system disease and is responding speciallyto traditional Chinese medicine（TCM）.Following LiGao's elaborated theoryof Zangqi Fashi （visceral qi being corresponding to the four seasons and five elements），this article proposed that the differentiation and treatment for CAG should be focused on middle jiao（spleen and stomach）.Based on the connection between the qi movement of spleen-stomach and the yin-yang changes of thefour seasons in nature，the etiology，pathogenesis， and treatment of CAG were analyzed.It is proposed that spleen-stomach deficiency is the root cause of CAG，and the internal generationof yin-fire isan important pathological state of CAG.Theprimary treatment principle for CAG is to tonify the spleen and stomach，and to subside yin fire.Inclinical treatment of CAG，theformulation of the prescriptions for tonifying or purging should be based on the properties and flavors of herbal medicines，and then the ascending and descending of qi movement in the human body are normalized，and the exiting and entering of qi movement are in order.In addition to medicinal treatment，dietary regulation is also emphasized for the prevention and treatment of CAG.

Keywords：chronic atrophic gastritis（CAG）；Zangqi Fashi；spleen-stomach deficiency；internal generation of yin-fire；tonifying the spleen and stomach；subsiding yin-fire；LiGao

慢性萎缩性胃炎（chronicatrophic gastritis，CAG）是指胃黏膜上皮反复受损导致固有腺体减少，在慢性炎症背景下，伴或不伴肠上皮化生（intestinalmetaplasia，IM）和（或）假幽门腺化生的一种胃癌前疾病1]，为Correa级联模式中的重要阶段。（剩余9221字）