[1]霍涌波,候咪,张宁,等.长安霍氏基于“实则阳明、虚则太阴”治疗慢性萎缩性胃炎理法探要[J].陕西中医,2026,(1):82-85,91.[doi:DOI:10.3969/j.issn.1000-7369.2026.01.014]
　HUO Yongbo,HOU Mi,ZHANG Ning,et al.An exploration of the therapeutic principles of the Chang’an HUO’s school in treating chronic atrophic gastritis based on the theory of “excess patterns involve the yangming,deficiency patterns involve the taiyin”[J].,2026,(1):82-85,91.[doi:DOI:10.3969/j.issn.1000-7369.2026.01.014]
点击复制

长安霍氏基于“实则阳明、虚则太阴”治疗慢性萎缩性胃炎理法探要

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2026年1期
页码:
82-85,91
栏目:
长安医学
出版日期:
2026-01-05

文章信息/Info

Title:
An exploration of the therapeutic principles of the Chang’an HUO’s school in treating chronic atrophic gastritis based on the theory of “excess patterns involve the yangming,deficiency patterns involve the taiyin”
作者:
霍涌波1; 候咪1; 张宁2; 焦若敏3
（1.延安市中医医院，陕西 延安 716000；2.陕西中医药大学，陕西 咸阳 712046；3.长春科技学院，吉林 长春 130600）
Author(s):
HUO Yongbo1; HOU Mi1; ZHANG Ning2; JIAO Ruomin3
(1.Yan’an Traditional Chinese Medicine Hospital,Yan’an 716000,China;2.Shaanxi University of Chinese Medicine,Xianyang 712046,China;3.Changchun University of Science and Technology，Changchun 130600，China)
关键词:
慢性萎缩性胃炎; 益气健脾; 温阳助运; 疏肝行气; 消食化滞
Keywords:
Chronic atrophic gastritis; Boost Qi and fortify the spleen; Warm Yang and promote transportation; Soothe the liver and move Qi; Disperse food and resolve stagnation
分类号:
R 573.32
DOI:
DOI:10.3969/j.issn.1000-7369.2026.01.014
文献标志码:
A
摘要:
慢性萎缩性胃炎（CAG）是临床常见病，有炎-癌转化风险。长安霍氏中医内科学术流派基于“实则阳明、虚则太阴”理论，认为其核心病机“太阴虚损，致病之本；阳明壅滞，邪滞病进；因虚致实，环环相扣”，构建“脾虚为本-因虚致实-虚实兼夹-瘀毒互结”的病机演变路径。基于“虚则太阴”，益气健脾、温阳助运，以立治病之本；基于“实则阳明”，疏肝行气、消食化滞，以复升降之职；因于“瘀毒互结”，清热解毒、活血化瘀，以祛滞留之邪。从整体观认识CAG发病及病机转化规律，治疗辨证与辨病相结合，用药权衡正邪力量对比，温清并用、补消兼施。现总结其论治CAG的学术思想与临床经验，旨在为治疗提供有益思路及借鉴。
Abstract:
Chronic atrophic gastritis (CAG) is a common clinical disease with the risk of inflammation-cancer transformation.Based on the theory of “Excess patterns involve the Yangming,deficiency patterns involve the Taiyin”,the Chang’an HUO’s school of internal medicine in traditional Chinese medicine posits that its core pathogenesis is “Taiyin deficiency and impairment as the root cause;Yangming stagnation and obstruction leading to disease progression;deficiency giving rise to excess,forming an interlocking cycle”.This constructs a pathogenetic evolution pathway:“Spleen deficiency as the root → Deficiency leading to excess → Intermingled deficiency and excess patterns → Interbinding of stasis and toxin”.Based on the concept that “Deficiency patterns involve the Taiyin”,treatment focuses on boosting Qi and fortifying the spleen,warming Yang and promoting transportation to establish the root of treatment.Based on the concept that “Excess patterns involve the Yangming”,treatment involves soothing the liver and moving Qi,dispersing food and resolving stagnation to restore the ascending and descending functions.Due to the “interbinding of stasis and toxin”,treatment includes clearing heat and resolving toxin,activating blood and dispelling stasis to eliminate lingering pathogenic factors.The understanding of CAG onset and pathogenetic transformation follows a holistic view,combining pattern differentiation and disease diagnosis in treatment.Herbal application carefully balances the relative strength of healthy Qi and pathogenic factors,employing warming and clearing methods simultaneously,as well as tonifying and dispersing techniques concurrently.This article summarizes the school’s academic thoughts and clinical experience in treating CAG,aiming to provide useful ideas and references for its management.

参考文献/References:

[1]吕宾,王彦刚,胡玥,等.慢性萎缩性胃炎中西医结合诊疗专家共识(2025年)[J].中国中西医结合消化杂志,2025,33(3):230-241.
[2]闫超,陕飞,李子禹.2020年全球胃癌负担分析:聚焦中国流行现状[J].中国肿瘤,2023,32(3):161-170.
[3]中华中医药学会脾胃病分会.慢性胃炎中医诊疗专家共识(2023)[J].中华中医药杂志,2023,38(12):5904-5911.
[4]清涧县科学技术委员会,清涧县卫生局.霍静堂医疗经验汇编[M].榆林:陕西省清涧县卫生局,1981:31-34.
[5]徐晴,王萍,姜艾利,等.从脾虚论治慢性萎缩性胃炎及胃癌前病变的思考[J].中华中医药学刊,2021,39(8):186-188.
[6]孙慧,崔瑞龙,宣晓红,等.王健教授治疗慢性萎缩性胃炎的临证经验[J].中医临床研究,2023,15(10):116-119.
[7]刘俊宏,李林蔓,符博雅,等.王道坤扶正化瘀法治疗慢性萎缩性胃炎的临证经验[J].中华中医药杂志，2023,38(12):5871-5875.
[8]游绍伟,詹亚梅,王文素,等.基于“脾虚宛滞”探讨慢性萎缩性胃炎“炎癌转化”与防治思路[J].中国实验方剂学杂志,2023,29(21):188-195.
[9]吴皓萌,黄绍刚,王凤云,等.基于胃微环境探讨中医药防治胃癌前病变的机制[J].中国实验方剂学杂志,2021,27(16):245-250.
[10]李玲,伍志伟,刘永琦,等.基于胃癌相关微生态变化探讨“脾胃-肠”轴的交互作用[J].中华中医药杂志,2017,32(4):1567-1569.
[11]卓祖顺,朱龙,张梦婷,等.基于胃黏膜损伤探讨慢性萎缩性胃炎脾胃虚弱证的微观内涵[J].时珍国医国药,2025,36(16):3110-3114.
[12]赵洁,魏登辉,任顺平,等.任顺平教授从“虚、瘀、逆、毒”论治慢性萎缩性胃炎[J].中医临床研究，2023,15(23):120-124.
[13]田世媛,陈晓芸.分析慢性萎缩性胃炎与巨幼细胞贫血的关系[J].当代医学,2019,25(8):22-25.
[14]纪云飞,王瑞君,李晓波.复方四君子汤的化学成分和药理作用研究进展[J].中草药,2016,47(5):837-843.
[15]张欢,李超,汲晨锋.药食同源党参化学成分、药理作用及应用研究进展[J].食品科学,2024,45(23):338-348.
[16]卓少华,丘远聪,郑俊德,等.人参皂苷Rg5调控lncRNA-PCAT12抑制胃癌细胞生长实验研究[J].陕西中医,2020,41(4):437-439.
[17]叶妮,王文升,张浩利,等.干姜的药理作用及其药对研究进展[J].中华中医药学刊,2024,42(12):206-209.
[18]王晓晴,孙允红,赵方舒,等.高良姜素的药理作用及机制研究进展[J].中药药理与临床,2023,39(8):115-120.
[19]徐秀梅,刘文建.香附药理作用及临床应用的进展[J].广东化工,2023,50(9):122-123，69.
[20]黄兹高,黄律,黄胜,等.黄芪建中汤合良附丸对慢性萎缩性胃炎患者胃黏膜血流量及血清氧化应激指标的影响[J].现代中西医结合杂志,2020,29(18):1998-2002.
[21]杨思雨,史汶龙,路平,等.枳实化学成分及药理作用研究进展[J].中成药,2023,45(7):2292-2299.
[22]于俊保,朱佳源,梅文亚,等.枳壳及其活性成分调节胃肠动力作用机制研究进展[J].中国实验方剂学杂志,2024,30(10):290-298.
[23]赵永艳,胡瀚文,彭腾,等.佛手的化学成分药理作用及开发应用研究进展[J].时珍国医国药,2018,29(11):2734-2736.
[24]王惠,李聃.香橼的化学成分和药理作用研究进展[J].中国民族民间医药,2024,33(6):63-73.
[25]董佳鑫,王海艳,喀麦隆,等.幽门螺杆菌感染致表皮生长因子及其受体表达上调与胃癌发生及发展机制关系研究进展[J].陕西医学杂志,2024,53(6):853-857.
[26]屈媛,王婷,付慧婕,等.丹参有效成分及药理作用研究进展[J].辽宁中医药大学学报,2024,26(9):172-176.
[27]魏巍,王冰瑶.莪术及其主要成分的药理作用研究进展[J].药物评价研究,2022,45(10):2154-2160.
[28]郭玺,刘盼茹,唐乙朝,等.三七皂苷成分及临床药理作用研究进展[J].南京中医药大学学报,2024,40(9):985-992.

相似文献/References:

[1]孙明明,李 聪,史 林.王庆国教授对慢性萎缩性胃炎的治疗经验探析[J].陕西中医,2019,(2):260.
　SUN Mingming,LI Cong,SHI Lin..Analysis on the treatment experience of chronic atrophic gastritis by professor WANG Qingguo[J].,2019,(1):260.
[2]钱元霞,汤玲珺,钱 祯,等.四逆散对慢性萎缩性胃炎癌前病变大鼠的作用及机制研究*[J].陕西中医,2019,(8):990.
　QIAN Yuanxia,TANG Lingjun,QIAN Zhen,et al.The effect of Sinisan on the rats of precancerous lesion of chronic atrophic gastritis and its mechanism[J].,2019,(1):990.
[3]闫 强,杨国强 △.健脾清胃汤治疗脾胃虚弱型慢性萎缩性胃炎疗效及对患者免疫功能的影响[J].陕西中医,2019,(8):1014.
　YAN Qiang,YANG Guoqiang..Effect of Jianpi Qingwei decoction on chronic atrophic gastritis of spleen and stomach deficiency and its influence on patients' immune function[J].,2019,(1):1014.
[4]杨宏升.安胃活血汤联合序贯法治疗慢性萎缩性胃炎胃癌前病变疗效研究[J].陕西中医,2019,(9):1195.
　YANG Hongsheng..Effect of Anwei Huoxue decoction combined with sequential therapy on gastric precancerous lesions of chronic atrophic gastritis[J].,2019,(1):1195.
[5]马佳乐 ,李慧臻.中医治疗慢性萎缩性胃炎研究进展*[J].陕西中医,2019,(11):1646.
　MA Jiale,LI Huizhen..Traditional Chinese medicine in the treatment of chronic atrophic gastritis[J].,2019,(1):1646.
[6]曾微微,麦联任,张 玲,等.健胃益脾汤治疗慢性萎缩性胃炎疗效及对患者胃蛋白酶原的影响*[J].陕西中医,2020,(11):1548.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.008]
　ZENG Weiwei,MAI Lianren,ZHANG Ling,et al.Effect of Jianwei Yipi decoction on treating chronic atrophic gastritis and its influence on pepsinogen[J].,2020,(1):1548.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.008]
[7]王 阳.基于络病理论探析慢性萎缩性胃炎“气络失和,毒损血络”病机*[J].陕西中医,2020,(11):1632.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.030]
　WANG Yang..Analysis of pathogenesis of chronic atrophic gastritis based on collateral disease theory[J].,2020,(1):1632.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.030]
[8]张紫涵,陈 俊,徐 丹.苦参碱联合胃复春片治疗慢性萎缩性胃炎疗效及对患者血清胃蛋白酶原亚群的影响[J].陕西中医,2021,(3):323.[doi:DOI:10.3969/j.issn.1000-7369.2020.03.013]
　ZHANG Zihan,CHEN Jun,XU Dan.Effect of matrine combined with Weifuchun tablet on efficacy and serum pepsinogen subgroup in patients with chronic atrophic gastritis[J].,2021,(1):323.[doi:DOI:10.3969/j.issn.1000-7369.2020.03.013]
[9]寇 媛,闻新丽,薛 峰.养胃清热化瘀汤治疗慢性萎缩性胃炎及癌前病变临床研究[J].陕西中医,2021,(9):1233.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.021]
　KOU Yuan,WEN Xinli,XUE Feng.Clinical study on Yangwei Qingre Huayu decoction in treatment of chronic atrophic gastritis and precancerous lesions[J].,2021,(1):1233.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.021]
[10]张 鹏,于 勇,万 强,等.补虚养胃汤加减治疗慢性萎缩性胃炎疗效及对患者胃肠功能的影响[J].陕西中医,2022,(1):66.[doi:DOI:10.3969/j.issn.1000-7369.2022.01.016]

备注/Memo

备注/Memo:
陕西省第二批中医学术流派传承工作室建设项目（SXZYLP-2024017）；陕西省延安市名中医工作室建设项目（延市卫函〔2023〕202号）
更新日期/Last Update: 2026-01-08