从“脾为之卫”谈胃癌前病变的辨治思路  

Discussion on Differentiation and Treatment of Precancerous Lesions of Gastric Cancer from "Spleen as the Defense"

作　　者：孙月明 陈琴[2] 郑榕 许若缨 黄铭涵[1] 李思汉 SUN Yueming;CHEN Qin;ZHENG Rong;XU Ruoying;HUANG Minghan;LI Sihan(The Second People's Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou Fujian China 350003;Union Hospital of Fujian Medical University,Fuzhou Fujian China 350003;Basic Medical College of Guangzhou University of Chinese Medicine,Guangzhou Guangdong China 510006)

机构地区：[1]福建中医药大学附属第二人民医院,福建福州350003 [2]福建医科大学附属协和医院,福建福州350003 [3]广州中医药大学基础医学院,广东广州510006

出　　处：《中医学报》2021年第12期2516-2520,共5页Acta Chinese Medicine

基　　金：福建省自然科学基金项目(2020J01253);福建省卫生健康委员会中青年骨干人才培养项目(2019-ZQN-79);福建中医药大学中医脾胃学科开放课题项目(X2019014-学科)。

摘　　要："脾为之卫"出自《灵枢·五癃津液别》,强调脾脏具有护卫机体、抵御外邪的功能。脾与胃水谷纳运、气机升降、燥湿相济的生理病理关系,是从"脾为之卫"论治胃癌前病变的基础。脾胃生理机能正常有赖于"脾为之卫"的功能正常。胃癌前病变虚、湿、瘀、滞等病理因素与脾"为卫"功能失常密切相关。临证辨治应以"脾为之卫"理论为指导,重视固护脾气、调理气机、散瘀舒络、祛湿除邪、固护胃阴等治则的应用,以及"辨病"与"辨证"思路的结合。"Spleen as the defense" comes from Wu Long Jin Ye Bie of Ling Shu,which emphasizes that the spleen has the function of protecting the body and resisting exogenous evil.The physiological and pathological relationship such as water and cereals digestion,Qi movement ascending-descending,and dryness and dampness counteract each other between Spleen and Stomach,is the basis for differentiation and treatment of precancerous lesions of gastric cancer(PLGC) from "Spleen as the defense".The normal physiological function of the Spleen and Stomach depends on the normal function of "the spleen as the Defense".PLGC elements include deficiency,dampness,stasis,stagnation,and other pathological factors that are closely related to the abnormal function of the Spleen "Defense".The clinical differentiation and treatment should be guided by the theory of "Spleen as the defense",and pay attention to the application of such treatment principles as the application of strengthening and protecting Spleen Qi,regulating Qi movement,dispersing stasis and relieving collaterals,removing dampness and eliminating evil;strengthening Stomach Yin,as well as the combination of "disease differentiation" and "syndrome differentiation".

关 键 词：胃癌前病变 脾为之卫 固护脾气 调理气机 散瘀舒络 祛湿除邪 固护胃阴 

分 类 号：R273[医药卫生—中西医结合]