从“浊阴凝痞”视角探究慢性胃炎辨治思路

Perspectives on the Diagnosis and Treatment of Chronic Gastritis Based on the Theory of “Turbid Yin Coagulation and Stagnation”

摘要: 慢性胃炎(chronic gastritis, CG)是一种临床常见的消化道疾病。在中医中属于“胃痞病”、“痞满”、“嘈杂”、“胃痛”等疾病范畴，根本上以脾胃虚弱为本，气滞、血瘀、痰浊为标。笔者从叶天士《临证指南医案》中“浊阴凝痞”视角出发，深入溯源“浊阴”的含义，探索其在慢性胃炎发病过程中的重要作用，以“浊阴凝痞”为基本病机，扶阳运气，化阴除痞为治疗大法，探究慢性胃炎辨治的思路。

Abstract: Objective: Chronic gastritis (CG) constitutes a prevalent clinical disorder of the gastrointestinal tract. In traditional Chinese medicine (TCM), it is categorized under the disease entities including weipi (gastric stuffiness), piman (distention and fullness), cazao (gastric distress and restlessness), weitong (epigastric pain) and analogous syndromes. Pathogenetically, it is rooted in deficiency of the spleen and stomach, with qi stagnation, blood stasis and phlegm turbidity as the secondary manifestations. From the academic perspective of “turbid yin coagulation and stagnation” proposed by Ye Tianshi in his monumental work Medical Cases as a Guide to Clinical Practice, this paper conducts an in-depth textual research on the connotation of “turbid yin”, and elucidates its pivotal role in the pathogenesis of chronic gastritis. Taking “turbid yin coagulation and stagnation” as the core pathogenesis, this study adopts the therapeutic principles of strengthening yang to regulate qi movement, resolving turbid yin and dispelling gastric stuffiness, thereby exploring the systematic thinking of syndrome differentiation and treatment for chronic gastritis.