慢性萎缩性胃炎（CAG）为临床常见的消化系统疾病，为中医药治疗的优势病种。该文围绕李杲所阐发的“脏气法时” 理论，认为辨治CAG需着眼于中焦脾胃。通过阐析脾胃气机运行与天地四时阴阳变化的联系，对CAG的病因病机及治疗进 行探讨。认为脾胃虚弱为CAG的起病之源，阴火内生为其重要的病理状态；“补脾胃，泻阴火”为CAG主要的治疗原则。临证 用药依据药物气味进行补泻遣方，使人体气机升降相因，出入循序。除用药治疗外，同时应注重调摄饮食。

Chronic atrophic gastritis（CAG） is a common clinical digestive system disease and is responding specially to traditional Chinese medicine（TCM）. Following Li Gao’s elaborated theory of Zangqi Fashi（visceral qi being corresponding to the four seasons and five elements）， this article proposed that the differentiation and treatment for CAG should be focused on middle jiao （spleen and stomach）. Based on the connection between the qi movement of spleen-stomach and the yin-yang changes of the four seasons in nature，the etiology，pathogenesis， and treatment of CAG were analyzed. It is proposed that spleen-stomach deficiency is the root cause of CAG，and the internal generation of yin-fire is an important pathological state of CAG. The primary treatment principle for CAG is to tonify the spleen and stomach，and to subside yin fire. In clinical treatment of CAG，the formulation of the prescriptions for tonifying or purging should be based on the properties and flavors of herbal medicines，and then the ascending and descending of qi movement in the human body are normalized，and the exiting and entering of qi movement are in order. In addition to medicinal treatment， dietary regulation is also emphasized for the prevention and treatment of CAG.

R259.733

佛山市自筹经费类科技计划项目（编号：2220001005030）