慢性胃痛辨治归要

目的　介绍慢性胃痛的临证辨治经验。方法　对近年来辨治的160例慢性胃痛进行回顾性分析。结果　以肝郁脾虚为主要临床表现的120例,其余40例或以胃阴亏虚或湿热内阻或瘀血停滞等为主要临床表现,但或多或少的都兼有肝郁脾虚的症状。另外,通过辨证分析认为胃痛及其伴随症状均是胃失和降的表现及延续,治则拟疏肝健脾、通降和胃,采用基本方治疗,获较好疗效。结论　肝郁脾虚、胃失和降是慢性胃痛的主要病机,治疗应始终以疏肝健脾、通降和胃为要旨。

Therapeutic approaches for chronic gastralgia based on differentiation of symptoms and signs

Objective To report our clinical experience with the treatment of chronic gastralgia on the basis of the differentiation of symptoms and signs. Method A total of 160 cases of chronic gastralgia we treated in recent years were reviewed. Results Among the 160 cases, 120 falls in the category characterized by the predominant clinical symptoms such as depression of liver-energy and spleen-asthenia. For the other 40 cases, their clinical symptoms are of deficiency of stomach-yin, and retention of damp-heat in the interior or accumulation of blood stasis constituted the major clinical presentations, but more or less featured by depression of liver-energy and spleen-asthenia. Through analysis by differentiation of the symptoms and signs, we were convinced that the major symptoms of chronic gastralgia and some accompanying minor symptoms were all the representation and extension of the underlying cause, disorder of stomach-energy. The treatment was therefore targeted at dispersing the depression of liver-energy and invigorating the spleen, smoothing and regulating the stomach-energy. The treatment adopts primary prescription and good effects were achieved. Conclusion The pathogenesis of chronic gastralgia predominantly lies in the depression of liver-energy and spleen-asthenia, together with disordered stomach-energy. The treatment should be implemented to disperse the depression of liver-energy and invigorate the spleen, with attention to smoothing and regulating the stomach-energy throughout the whole treatment course.