“主客交”理论在胃癌前病变中的应用  

Application of Theory of "Pathogen Invading Nutrient and Blood Aspects" in Precancerous Lesions of Gastric Cancer

作　　者：豆鹏程 舒劲[2] DOU Pengcheng;SHU Jin(Clinical College of Chinese Medicine,Gansu University of Chinese Medicine,Lanzhou 730030,China;Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,China)

机构地区：[1]甘肃中医药大学中医临床学院,兰州730030 [2]甘肃省中医院,兰州730050

出　　处：《中国实验方剂学杂志》2023年第20期175-180,共6页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(82060860);甘肃省自然科学基金项目(21JR7RA588)。

摘　　要：胃癌是消化系统最为常见的恶性肿瘤之一,发病率较高,总体生存率偏低,治疗预后差,已成为威胁人们生命健康的重大公共卫生问题。由于当前胃癌的发病机制仍未完全清楚,实施一级预防较为困难,故而对胃癌的二级预防,即胃癌前病变的研究显得极其重要,也成为许多研究者关注的重点。胃癌前病变是发生炎性病变的胃黏膜转化为胃癌的关键病理环节,通常包含慢性萎缩性胃炎、肠上皮化生和异型增生。研究证实,随着胃黏膜病变程度不断加重,胃癌发生率和风险也随之增高。因此,早期诊断、有效干预胃癌前病变这一病理环节是胃癌防治及降低其发病率的一种关键措施,且意义重大。越来越多研究表明,中医药能截断和逆转胃黏膜的病理分级,能有效改善患者临床症状,提升生活质量,且不良反应小,复发率低,具有独特的优势和特色。“主客交”理论由温病医家吴有性在《温疫论》中首次提出,原用于对温疫病后期的变证治疗,后经不同医家丰富和发展,现多用来指导多种慢性痼疾的治疗。胃癌前病变属于临床常见的疑难疾病,其演变过程中本虚标实,虚实夹杂的病机特点与“主客交”正虚邪客,客邪胶结于血脉的核心病机相契合,二者在治则上也彼此相通。故文章以“主客交”理论为切入点,在该理论视角下阐述中医药对胃癌前病变的干预作用,体现其的指导和应用价值,同时为疾病临床治疗提供新思路。Gastric cancer is one of the most common malignant tumors of the digestive system,with a high incidence,a low overall survival rate,and poor prognosis after treatment.It has become a major public health problem that threatens the lives and health of people.Since the pathogenesis of gastric cancer is still not fully unraveled,it is difficult to implement primary prevention.Therefore,the research on secondary prevention of gastric cancer,i.e.,precancerous lesions of gastric cancer,is extremely important and has become the focus of many researchers.Precancerous lesions of gastric cancer are the key pathological links in the transformation of inflammatory lesions of gastric mucosa into gastric cancer,including chronic atrophic gastritis,intestinal metaplasia,and dysplasia.Relevant studies have confirmed that with the aggravation of gastric mucosal lesions,the incidence and risk of gastric cancer also increase.Therefore,early diagnosis and effective intervention in the pathological link of gastric precancerous lesions is a key measure to prevent and reduce the incidence of gastric cancer,with great significance.More studies have shown that traditional Chinese medicine(TCM)can truncate and reverse the pathological grading of gastric mucosa,and can also effectively improve the clinical symptoms and quality of life of patients,with few adverse reactions and low recurrence rate,which has unique advantages and characteristics.The theory of''pathogen invading nutrient and blood aspects''was first proposed by WU Youxing,a febrile disease doctor,in Treatise on Pestilence(《温疫论》).It was originally used for the treatment of syndrome changes in the late stage of febrile epidemics,but after being enriched and developed by different doctors,it is now mostly used to guide the treatment of various chronic diseases.Precancerous lesions of gastric cancer are a common and difficult disease in clinical practice.Its evolution process is characterized by asthenia in origin and sthenia in superficiality and deficiency-excess in co

关 键 词：主客交理论 胃癌前病变 胃癌 病理环节 中医药 

分 类 号：R22[医药卫生—中医基础理论] R242[医药卫生—中医学] R2-031R287