Clinical experience of national TCM master LIAN Jianwei in treating chronic atrophic gastritis based on syndrome differentiation and pulse diagnosis

<x>Abstract</x> This study summarizes the clinical experience of professor LIAN Jianwei, a nationally renowned traditional Chinese medicine (TCM) practitioner, in treating chronic atrophic gastritis (CAG) with syndrome differentiation based on pulse-taking. Professor LIAN emphasizes the importance of pulse diagnosis in TCM clinical practice, focusing on the normal and variant aspects of pulse methods, and centers on the dynamic changes of the “Guan pulse” to accurately determine the functional status of the spleen and stomach based on pulse variations, thereby formulating personalized treatment plans. For patients with a slow and moderate pulse, spleen and stomach deficiency and dampness due to spleen deficiency are often identified, and treatment mainly focuses on strengthening the spleen, resolving dampness, and boosting Qi to aid transportation, usually with modifications of Shenling Baizhu San. When the left Guan pulse is string-like and the right Guan pulse is slow and moderate, it indicates liver depression and spleen deficiency, and Xiaoyao San is commonly used to soothe the liver, nourish the blood, and strengthen the spleen, harmonizing the liver and spleen. If the right Guan pulse is large and the left Guan pulse is string-like, it mostly belongs to liver and stomach Qi stagnation, and Bupleurum Liver-soothing powder is often used to soothe the liver, regulate Qi, and harmonize the stomach. A large and empty right Guan pulse suggests insufficiency of Central Qi, and Buzhong Yiqi Tang is commonly used to tonify Qi and soothe the liver. In terms of medication, professor LIAN pays attention to patients’ dietary habits and combines methods of eliminating dampness, promoting digestion, and activating blood circulation to improve symptoms and reverse atrophy.