张志远治疗慢性胃病经验

张志远老师认为外感邪气、饮食不节、情志内伤是慢性胃病的主要发病原因,升降失常、气运不达为主要病机,气滞、湿热是关键病理因素,病位在胃,与肝、脾关系密切,病性是本虚标实、寒热错杂。张志远认为胃病患者久病伤阳、伤阴、易致瘀,治疗上遵调理升降、健脾和胃之大法,同时针对兼夹病机提出疏泄郁气,和中养胃、寒热并用,疏补同开的治疗方法。张老师认为,慢性胃病反复发作,发作期与恢复期往往交替出现,故论治胃病谨遵治脾必知其欲升,治胃必知其欲降。张老师临证用药特点:寒热兼苦辛、缓肝兼益胃、清补不壅塞、甘润益胃阴、慎用攻下药。

Zhang Zhi-yuan's Experience of Treating Chronic Stomach Disorder

Professor Zhang Zhi-yuan thinks that exogenous factors,improper diet and emotional disorder are the main reasons for chronic stomach disorder;Disorder of ascending and descending,and unsmooth qi movement are the major pathogenesis;Qi stagnation,dampness and heat are the key pathological factors;Its disease place lies in the stomach and has a close relationship with the liver and the spleen;The nature of the disease is asthenia root and sthenia tip,intermingled cold and heat.Zhang thinks that long-time stomach disorder hurts yang,yin and easily leads to blood stasis,so the treatment should regulate ascending and descending,strengthening the spleen and harmonize the stomach.At the same time,in terms of intermingled pathogenesis,the treatment should focus on disperse the stagnated qi,harmonize the middle energizer and nourish the stomach,use cold and hot medicine together,purging and reinforcing together.Zhang thinks that chronic stomach trouble appears recurrently,recurrent episodes and convalescence often appear alternately,so in order to cure it,doctors should know that treating the spleen must know its ascending feature,and treating the stomach must know its descending feature.Professor Zhang's clinical drug-use features are as follows:cold,heat and bitter,pungent drugs are used together;Relieving the liver and nourish the stomach should be paid attention to at the same time;Reinforcing and purging together;Nourishing the stomach yin should use drugs with sweet and moistening features;Be careful to use purging drugs.