李振华教授脾胃肝脏腑同治慢性胃炎的理论探讨

发布时间：2019-06-18 23:14

【摘要】：“国医大师”李振华教授出身中医世家,自幼受祖辈中医思想的熏陶,精研古代各家学说,从医、教、研工作60余载,善于诊治内科疑难杂症,尤其是对脾胃病,如慢性胃炎的中医治疗具有独到建树。纵观目前中医诸家对于慢性胃炎的临床治疗,多以脾胃、肝胃、肝脾等论治,缺乏统一认识,李振华教授潜心研究慢性胃炎数十年,结合本病的临床特点,大胆创新,提出脾胃肝三脏腑同治理论。因此,笔者在李振华教授和导师郭淑云教授指导下,广泛查阅中医经典著作,以中医理论为核心,探讨脾胃肝三脏腑与慢性胃炎的密切关系,为脾胃肝脏腑同治慢性胃炎理论的提出及应用奠定相应的基础。本论文将从以下四个方面进行论述:第一部分:溯本求源,脾胃肝脏腑同治慢性胃炎的学术渊源与理论基础。从《黄帝内经》、《伤寒论》、《脾胃论》、《临证指南医案》等中医典籍中,梳理祖国医学对慢性胃炎的诊治,探寻李振华教授脾胃肝脏腑同治慢性胃炎理论的思想源头。第二部分:深入研究,从中医理论及临床角度探讨脾胃肝三脏腑之间的密切关系。联系脾、胃、肝三脏腑其本身的生理功能和病理特点,由点至面,推及脾病传胃、胃病传脾、脾病传肝、肝病传脾、胃病传脾、胃病传肝、肝病传胃、肝病传脾,再由面成网,形成脾胃肝脏腑同病,为脾胃肝脏腑同治慢性胃炎思想的形成提供有力的理论支撑。第三部分:专题探讨,李振华教授脾胃肝脏腑同治慢性胃炎理论的提出。李振华教授对于慢性胃炎的中医临床诊疗,其独特见解主要表现在:1.认为慢性胃炎的病位主要在胃,与肝脾密切相关;2.提出脾胃气虚是慢性胃炎的基本病机;3.倡导脾气虚,胃气滞,肝气郁是慢性胃炎发生的重要基础;4.强调健脾,和胃,疏肝脏腑同治是治疗慢性胃炎的主要方法;5.推崇香砂六君子汤,用药尊古而不泥古。第四部分:理成实践,李振华教授对慢性胃炎的辨证论治及经典医案。李振华教授将慢性胃炎主要化分为三个证型。1.脾胃气虚型,治法以健脾益气,和胃化滞为主,方用香砂六君子汤加减;2.肝胃不和型,治法以疏肝健脾,理气和胃为主,方用逍遥散加减;3.胃阴亏虚型,治以养阴和胃,理气清热,方选沙参麦冬汤加减。
[Abstract]:Professor Li Zhenhua, a master of Chinese medicine, came from a family of traditional Chinese medicine and was influenced by his ancestors' thought of traditional Chinese medicine since childhood. He has studied the ancient theories, practiced medicine, taught and studied for more than 60 years, and is good at the diagnosis and treatment of internal medicine, especially for the treatment of spleen and stomach diseases, such as chronic gastritis. Throughout the current clinical treatment of chronic gastritis in traditional Chinese medicine, most of them are treated by spleen and stomach, liver and spleen, but lack of unified understanding. Professor Li Zhenhua devoted himself to studying chronic gastritis for decades, combined with the clinical characteristics of the disease, boldly innovated, and put forward the theory of treating the three internal organs of spleen, stomach and liver. Therefore, under the guidance of Professor Li Zhenhua and Professor Guo Shuyun, the author extensively consulted the classical works of traditional Chinese medicine and took the theory of traditional Chinese medicine as the core to explore the close relationship between the three viscera of spleen and stomach and chronic gastritis, so as to lay the corresponding foundation for the theory and application of the theory of simultaneous treatment of chronic gastritis. This paper will discuss from the following four aspects: the first part: tracing back to the source, the academic origin and theoretical basis of the treatment of chronic gastritis with spleen, stomach, liver and viscera. This paper combs the diagnosis and treatment of chronic gastritis in traditional Chinese medicine, such as Huangdi Neijing, Treatise on febrile Diseases, spleen and stomach Theory and Clinical Guide Medical record, and explores the ideological source of Professor Li Zhenhua's theory of treating chronic gastritis with spleen, stomach, liver and viscera. The second part: in-depth study, from the traditional Chinese medicine theory and clinical point of view to explore the close relationship between spleen, stomach and liver. Connect the physiological function and pathological characteristics of spleen, stomach and liver organs, from point to face, push spleen disease, liver disease, spleen disease, The third part: special discussion, Professor Li Zhenhua spleen, stomach, liver and viscera treatment of chronic gastritis theory. Professor Li Zhenhua's unique views on the clinical diagnosis and treatment of chronic gastritis are as follows: 1. It is considered that the location of chronic gastritis is mainly in the stomach, which is closely related to the liver and spleen. It is pointed out that deficiency of spleen and stomach qi is the basic pathogenesis of chronic gastritis. Advocating deficiency of temper, stagnation of stomach qi and stagnation of liver qi are the important basis for the occurrence of chronic gastritis. It is emphasized that invigorating the spleen, soothing the stomach and soothing the liver and viscera are the main methods for the treatment of chronic gastritis. Praise Xiangsha six gentleman soup, the use of medicine to respect the ancient but not mud ancient. The fourth part: rational practice, Professor Li Zhenhua's syndrome differentiation and treatment of chronic gastritis and classical medical record. Professor Li Zhenhua divided the main features of chronic gastritis into three syndrome types. Spleen and stomach qi deficiency type, the treatment is mainly to invigorate the spleen and benefit qi, and stomach stagnation, the prescription with Xiangsha Liujunzi decoction to add and subtract; 2. Liver and stomach disharmony type, the treatment method is to soothe the liver and invigorate the spleen, regulate qi and stomach, the prescription uses Xiaoyao powder to add and subtract; 3. Stomach yin deficiency type, treatment to nourish yin and stomach, regulate qi and clear heat, the choice of sand ginseng and Ophiopogon officinalis decoction to reduce.
【学位授予单位】：河南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R259

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