[1]武文玉,许爱丽,孙巍琪,等.基于“胃阳不旺、浊阴易聚”探讨慢性萎缩性胃炎寒热错杂证病机及诊疗[J].陕西中医,2026,(4):517-521.[doi:DOI:10.3969/j.issn.1000-7369.2026.04.016]
　WU Wenyu,XU Aili,SUN Weiqi,et al.Exploring the pathogenesis diagnosis and treatment of chronic atrophic gastritis with intermingled cold-heat syndrome based on “insufficient stomach Yang and easy accumulation of turbid Yin”[J].,2026,(4):517-521.[doi:DOI:10.3969/j.issn.1000-7369.2026.04.016]
点击复制

基于“胃阳不旺、浊阴易聚”探讨慢性萎缩性胃炎寒热错杂证病机及诊疗

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2026年4期
页码:
517-521
栏目:
学术探讨
出版日期:
2026-04-05

文章信息/Info

Title:
Exploring the pathogenesis diagnosis and treatment of chronic atrophic gastritis with intermingled cold-heat syndrome based on “insufficient stomach Yang and easy accumulation of turbid Yin”
作者:
武文玉1; 许爱丽1; 孙巍琪1; 韩广卉1; 周婷婷1; 李浩1; 2; 张惠瑶1; 2; RYUGABO1（韩国）; 张涛1; 杨洋1; 魏玮1
（1.中国中医科学院望京医院，北京 100102；2.广州中医药大学，广东 广州 510006）
Author(s):
WU Wenyu1; XU Aili1; SUN Weiqi1; HAN Guanghui1; ZHOU Tingting; LI Hao1; 2; ZHANG Huiyao1; 2; RYUGABO1; ZHANG Tao1; YANG Yang1; WEI Wei1
(1.Wangjing Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China;2.Traditional Chinese Medicine University of Guangzhou,Guangzhou 510006,China)
关键词:
慢性萎缩性胃炎; 胃阳不旺; 浊阴易聚; 寒热错杂; 半夏泻心汤
Keywords:
Chronic atrophic gastritis; Insufficient stomach Yang; Easy accumulation of turbid Yin; Simultaneous occurrence of cold and heat; Banxia Xiexin decoction
分类号:
R 573.3
DOI:
DOI:10.3969/j.issn.1000-7369.2026.04.016
文献标志码:
A
摘要:
慢性萎缩性胃炎病理改变包括胃黏膜固有腺体丢失或萎缩，伴有肠上皮化生或异型增生，与上消化道癌前病变相关。阳以动为功，阴以静为用，“胃阳不旺，浊阴易聚”出自叶天士《临证指南医案》，强调阳明不运，中土失司，阳气不足、阴阳失衡使得气机升降失衡、寒热错杂而致阴邪内生。现基于“胃阳不旺，浊阴易聚”理论并结合研究团队魏玮教授以“虚、滞、郁、瘀”为核心病机治疗消化系统疾病癌前病变的临床经验，对慢性萎缩性胃炎寒热错杂证的形成机制及诊治进行探讨，为中医治疗消化系统优势病种提供临证思路。
Abstract:
Chronic atrophic gastritis (CAG) is characterized by the loss or atrophy of intrinsic gastric mucosal glands,often accompanied by intestinal metaplasia or dysplasia,and is closely associated with precancerous lesions of the upper gastrointestinal tract.In traditional Chinese medicine (TCM),“Yang governs movement while Yin governs tranquility”.The theory of “insufficient stomach Yang leading to easy accumulation of turbid Yin” is derived from Ye Tianshi’s Guide to Clinical Practice with Medical Cases,emphasizing the dysfunction of Yangming (stomach and large intestine) and the impairment of middle energizer function.This theory reflects that insufficient Yang Qi and imbalance between Yin and Yang result in disordered Qi movement,intermingled cold and heat,thereby inducing the endogenous production of Yin pathogens.Based on the aforementioned TCM theory and the clinical experience of professor WEI Wei’s research team,who proposes “deficiency,stagnation,stagnation of pathogens,and blood stasis” as the core pathogenesis for treating precancerous lesions of digestive system diseases,this study explores the pathogenesis,diagnosis,and treatment of CAG with the syndrome of intermingled cold and heat.It aims to provide clinical insights for the TCM treatment of dominant diseases in the digestive system.

参考文献/References:

[1]YIN Y,LIANG H,WEI N,et al.Prevalence of chronic atrophic gastritis worldwide from 2010 to 2020:An updated systematic review and meta-analysis[J].Ann Palliat Med,2022,11(12):3697-3703.
[2]WANG L,DING X,LI P,et al.Efficacy and safety of weifuchun tablet for chronic atrophic gastritis:A systematic review and meta-analysis[J].PLoS One,2023,18(4):e0284411.
[3]BAI Z,WANG H,SHEN C,et al.The global,regional,and national patterns of change in the burden of nonmalignant upper gastrointestinal diseases from 1990 to 2019 and the forecast for the next decade[J].Int J Surg,2025,111(1):80-92.
[4]GAO M J,LI S B,ZHU X J,et al.Analysis of risk factors for gastric cancer and precancerous lesions:A case-control study[J].J Dig Dis,2024,25(11):674-684.
[5]BRAY F,LAVERSANNE M,SUNG H,et al.Global cancer statistics 2022:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin,2024,74(3):229-263.
[6]LIAO W,WANG J,LI Y.Natural products based on Correa’s cascade for the treatment of gastric cancer trilogy:Current status and future perspective[J].J Pharm Anal,2025,15(2):101075.
[7]方霜霜,独思静,杨洋,等.半夏泻心汤方证述义[J].辽宁中医杂志,2023,50(9):45-47.
[8]叶天士.临证指南医案[M].北京:人民卫生出版社,2018:19-21.
[9]张景岳.景岳全书[M].太原:山西科学技术出版社,2017:183-184.
[10]佚名.中藏经[M].北京：人民卫生出版社，2023:103.
[11]黄元御.四圣心源[M].北京:中国中医药出版社，2009:93.
[12]邹玲孜,朱莹.基于“土壅木郁”探讨慢性萎缩性胃炎合并焦虑状态的论治[J].陕西中医,2025,46(10):1371-1375.
[13]佚名.黄帝内经·素问[M].北京:人民卫生出版社，2005:13-24.
[14]朱震亨.丹溪心法[M].北京:人民卫生出版社，2005:32.
[15]张金环,张建伟.半夏泻心汤联合标准四联疗法对萎缩性胃炎患者Hp清除率、免疫功能及炎症因子的影响[J].河南中医,2025,45(8):1175-1179.
[16]饶显俊,黄国栋,钱紫星,等.基于胃络失养病机探究慢性萎缩性胃炎“炎-癌转化”的全链条防治[J].时珍国医国药,2025,36(21):4117-4121.
[17]王雨鸽,许静茹,王俞铧,等.刘启泉教授基于“随变而调气”论治慢性萎缩性胃炎[J].陕西中医,2022,43(2):236-239.
[18]王杰,杜朋丽,董佳琪,等.黄连碱对慢性萎缩性胃炎大鼠PI3K/Akt/mTOR信号通路的影响[J].中国实验方剂学杂志,2024,30(18):117-124.
[19]向阳,黄琼,袁林.黄连半夏药对治疗慢性萎缩性胃炎作用机制研究[J].天然产物研究与开发,2022,34(11):1822-1831.
[20]YANG Y,WANG L,ZHANG C,et al.Ginsenoside rg1 improves alzheimer’s disease by regulating oxidativestress,apoptosis,and neuroinflammation through Wnt/GSK-3β/β-catenin signaling pathway[J].Chem Biol Drug Des,2022,99(6):884-896.
[21]亓雪,张颖颖.干姜的化学、药理研究进展[J].山东化工,2018,47(14):41-42.
[22]钟丰羽.基于数据挖掘探讨中医药治疗脾胃湿热型慢性萎缩性胃炎的用药规律研究[D].南宁：广西中医药大学,2024.
[23]国嵩,毛心勇,从禹,等.魏玮教授基于“滞、郁、虚、瘀”四因致病假说的用药规律及思路[J].中国中西医结合消化杂志,2020,28(5):386-389.
[24]从禹,王亚杰,苏晓兰,等.“调枢通胃”法在慢性萎缩性胃炎中的应用及魏玮教授临床经验[J].海南医学院学报,2021,27(1):66-70.
[25]魏玮,荣培晶,陈建德,等.虚、滞、瘀、郁——现代慢性疾病中医病机新认知[J].中国中西医结合杂志,2020,40(10):1264-1267.

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,(4):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,(4):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,(4):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,(4):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,(4):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,(4):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,(4):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,(4):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,(4):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:
国家重点研发计划项目（2023YFC3503600）；国家自然科学基金区域创新发展联合基金资助项目（U22A20375）；国家中医药传承与创新团队项目（ZYYCXTD-C-202210）；中国中医科学院望京医院自选课题（WJYY-XZKT-2023-15）
更新日期/Last Update: 2026-04-05