【作者】 杜琳；

【导师】 单兆伟；

【作者基本信息】 南京中医药大学 ， 中医内科学， 2005， 博士

【摘要】 论文以中医理论为指导，基于导师单兆伟教授研究诊治慢性萎缩性胃炎(Chronic atrophic gastritis，CAG)的学术经验，以“气虚血瘀”为主线，探索中医药对CAG的因、理、证、治的认识，研讨益气活血法及其方药的具体运用，归纳总结临床试验及动物实验的结果，探究其对CAG的作用机制。全方共分七个部分。 第一部分：探讨了CAG的中医病名。目前认为“胃痞”在症状、病机、病位等方面都概括了CAG的主要特点，较适合做CAG的中医病名。 第二部分：对CAG的基本病因病机进行了深入的探讨。指出病因有外感和内伤之分，但更重于内伤。CAG的临床表现虽然缺乏特异性，但仍有其基本的病机和病理变化。文中从三个方面阐述了导师对本病的认识：(一) 脾胃气虚乃发病之本；(二) 瘀血阻络为致病之标；(三) 气虚血瘀为病机关键。 第三部分：通过分析CAG中医药治疗现状及对CAG分型论治现状的流行病学调查，明确提出气虚血瘀证是CAG的主要常见证型，“益气活血”是CAG的主要治疗法则，探讨了气虚血瘀证的症状学基础、益气活血法的现代研究依据及其方药的组方意义和主要药物的作用。 第四部分：汇总了“仁术健胃颗粒”的临床试验和动物实验的结果，及大鼠CAG癌前期病变气虚血瘀证动物模型的研制方法。 第五、六部分：介绍了导师辨治CAG各种临床主要表现如痞满、胃脘痛、肠化及异型增生、Hp感染、胆汁反流的证治经验，并逐一探讨了导师在临证中如何从整体与局部、辨证与辨病、宏观与微观、已病与未病等方面把握本病，分析了中医特色和西医优势，并提出了CAG患者的饮食宜忌。 附篇部分：选录了导师诊余对弟子授业解惑时的几篇文章加以整理分析，以资对导师的学术思想作进一步的补充说明；并从分子生物学、遗传学、免疫学等方面对CAG这一种多病因性疾病的发病机理略作总结，以了解最新动态、展望新的研究思路。更多还原

【Abstract】 Under the guidance of traditional Chinese medicine (TCM), based on the experience on chronic atrophic gastritis (CAG) of professor Shan Zhaowei, with the thread of "qi deficiency and blood stasis" , this paper explores the etiology、pathogenesis、differentiation and treatment of CAG, discusses the method of replenishing qi and promoting the circulation of blood and the clinical application of its herbs, summarizes the results of clinical trials and animal experiments. Seven parts are included.The first part probes the corresponding name of CAG in TCM. So far "Wei Pi" is thought to be most suitable, for which reflects the characteristics of its symptoms, pathogenesis and location.The second part deeply discusses the etiology and pathogenesis of CAG. Both the exogenous pathogenic factors and internal injuries can cause the disease, but the latter is more important. Despite the unspecific symptoms of CAG, the basic pathogenesis is still regular. This part elaborates the supervisor’s recognition of CAG from three aspects. 1, spleen and stomach deficiency is the Ben of CAG; 2, retaining of blood stasis in stomach channel is the Biao of CAG; 3, qi deficiency and blood stasis is the key of pathogenesis.Through the epidemiological survey on the treatment of CAG with TCM and differentiation of CAG, the third part puts forward that the syndrome of qi-deficiency and blood-stasis is the principal syndrome of CAG, and that the method of replenishing qi and promoting the circulation of blood is the major treatment principle of CAG. This part also discusses the symptom basis of qi-deficiency and blood-stasis syndrome, explores the experimental foundation of the method of replenishing qi and promoting the circulation of blood, probes the meaning of its prescription and the function of major herbs.更多还原