1. Chronic Gastritis

1. Chronic Gastritis

Historically, gastritis was categorized into three types: superficial, hypertrophic, and atrophic. Recently, experts have discovered that these three pathological changes often coexist within the same stomach. Atrophic gastritis is the most common type, as it is characterized by the most widespread pathological changes. Therefore, it is collectively referred to as atrophic gastritis. Some patients are classified into two types based on the presence or absence of antibodies against gastric wall cells: Type A and Type B. Type A antibodies are positive, and the primary lesions occur in the body of the stomach. Because the body of the stomach is the primary functional area of the stomach, digestive function is significantly impaired in this type, with increased gastric acid secretion—particularly affecting the absorption of B vitamins, leading to anemia. The infiltration of gastric wall cells is predominantly lymphocytic, resulting in relatively mild local inflammation. Moreover, the stomach cavity is relatively large, allowing for a greater dilution of sensitive substances, which makes localized pain less pronounced. In summary, this type is primarily characterized by overall deficiency, abdominal distension, and disturbances in digestive and absorptive functions. On the tongue, this type presents with a thick, swollen tongue. Task output rules: Translate this markdown block from Chinese to English. Preserve markdown markers, links, and formatting. Keep headings and list structure unchanged. Return only the translated block.

Input: Tall grass is thin and white, with a deep, fine pulse often observed. From the perspective of traditional Chinese medicine diagnosis and treatment, these cases are typically attributed to deficiency of spleen and stomach qi, or dampness stagnation in the middle burner.

In such cases, the principle should be to tonify qi and strengthen the spleen, regulate qi and dry dampness; commonly used formulas include Xiangsha Liu Junzi Tang, Liangfu Wan, Da Xiao Jian Zhong Tang, and Lizhong Tang with additions. Adding Luowaleng, Sheng Longmu, and Wuchige can lead to effective treatment. For Type B patients, the gastric parietal cell antibodies are negative, and most lesions are concentrated in the antrum of the stomach. Since the body of the stomach is healthy and digestive function is mostly normal, the overall health condition of these patients is often better than that of Type A patients. However, in this type of gastric wall infiltration, neutrophilic polymorphonuclear cells are the most common, with pronounced local inflammatory manifestations. Moreover, the antrum serves as the vestibule of the pylorus; when food and fluids pass through here, they often stimulate the gastric mucosa due to the movement of the gastric end before entering the pylorus, leading to increased local pain. In summary, this type generally presents with good overall health, with no obvious signs of deficiency syndrome; however, gastric pain is often more prominent. Common tongue appearances include red tongue with yellowish greasy coating, and strings of pulse are also frequently observed. Traditional Chinese medicine often diagnoses this condition as damp-heat in the middle burner, qi stagnation, and blood stasis; the treatment principles involve clearing heat and drying dampness, regulating qi and activating blood circulation. Commonly used formulas include Banxia Xie Xin Tang, Huanglian Tang, Sanhuang Xie Xin Tang, Huanglian Jiedu Tang, Qingwei San, Danyin Yin, and 204 gastric medicines (Xiangfu, Yuanhu, Mingfang, Suiwaleng).

The pathology of superficial gastritis is similar to that of atrophic gastritis; because the condition is relatively mild, clinical treatment often follows the aforementioned therapeutic approaches.