针药结合治疗幽门螺杆菌感染性慢性胃炎研究进展*

作者：毛辰悦1,2，张佳宝1，鲁 望1，赵海音1

单位：1.上海中医药大学附属龙华医院，上海 200032； 2.上海中医药大学，上海 201203

引用：引用：毛辰悦，张佳宝，鲁望，赵海音.针药结合治疗幽门螺杆菌感染性慢性胃炎研究进展[J].中医药导报,2026,32(5):157-162.

DOI：10.13862/j.cn43-1446/r.2026.05.025

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摘要：

通过文献阅读与整理，阐述针药结合治疗幽门螺杆菌感染性慢性胃炎的研究进展。西医学认为幽门螺杆菌通过特殊结构黏附胃黏膜，释放毒素引发炎症级联反应，导致胃黏膜损伤、萎缩，甚至癌变，治疗以含铋剂的四联疗法为主，联合微生态制剂可辅助调节胃内菌群。中医学将该病归为“胃脘痛”等范畴，病因涵盖脾胃虚弱、湿热、饮食不节及情志失调等，针对肝胃不和、脾胃湿热等6种证型，辨证论治分别施以柴胡疏肝散、清中汤等方剂治疗。在此基础上采用针药结合方案，针刺三阴交、足三里等穴位联合西医四联疗法或加味香砂六君子汤等中药方剂；针灸如温针灸联合西药或中药四君子汤、黄芪建中汤等；穴位埋线联合西药或中成药疏肝和胃胶囊；穴位贴敷或耳穴贴压搭配西药或化瘀理气和胃汤等方剂。上述依证选方配穴，协同调节气血与脏腑功能，能显著提升临床有效率与幽门螺杆菌根除率，为临床治疗提供了多元思路与实践依据。

关键词：幽门螺杆菌；慢性胃炎；针药结合；综述

Abstract：

Through literature reading and analysis, this article elaborates on the research progress of combined acupuncture and medication therapy in the treatment of Helicobacter pylori (Hp)-associated chronic gastritis. Western medicine believes that Hp adheres to the gastric mucosa through special structures and releases toxins to trigger an inflammatory cascade, leading to gastric mucosal injury, atrophy, and even carcinogenesis. The main treatment is bismuth-containing quadruple therapy, combined with probiotics to assist in regulating the gastric microbiota. In TCM, this disease is classified into categories such as "stomach epigastric pain". The etiologies include spleen-stomach deficiency, dampness-heat, improper diet, and emotional disorders. Based on syndrome differentiation, six patterns such as liver-stomach disharmony and spleen-stomach dampness-heat are treated with formulas such as Chaihu Shugan San (柴胡疏肝散) and Qingzhong Tang (清中汤), respectively. On this basis, a combined acupuncture and medication approach is adopted. Acupuncture at points such as Sanyinjiao (SP6) and Zusanli (ST36) combined with Western quadruple therapy or modified Chinese herbal formulas such as Xiangsha Liujunzi Decoction (香砂六君子汤); warm needling combined with Western medicine or Chinese formulas such as Sijunzi Tang (四君子汤) and Huangqi Jianzhong Tang (黄芪建中汤); catgut embedding at acupoints combined with Western medicine or Chinese patent medicine Shugan Hewei Capsule (疏肝和胃胶囊); and acupoint application or auricular point pressing combined with Western medicine or formulas such as Huayu Liqi Hewei Decoction (化瘀理气和胃汤) are used. The selection of formulas and acupoints based on syndrome differentiation synergistically regulates qi, blood, and zang-fu organ functions, significantly improving clinical efficacy and Hp eradication rates, providing diverse ideas and practical bases for clinical treatment.

Key words：Helicobacter pylori; chronic gastritis; combined acupuncture and medication; review

发布时间：2026-05-23

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