从脾与能量代谢认识慢性胃炎“炎-癌转化”发生机制  

Mechanism of“Inflammation-cancer Transformation”in Chronic Gastritis from the Perspective of Spleen and Energy Metabolism

作　　者：田依冰 李中玉 温艳东 TIAN Yibing;LI Zhongyu;WEN Yandong(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100102,China;Eye Hospital of China Academy of Chinese Medical Sciences,Beijing 100000,China)

机构地区：[1]中国中医科学院西苑医院,北京100102 [2]中国中医科学院眼科医院,北京100000

出　　处：《世界中医药》2023年第19期2786-2789,共4页World Chinese Medicine

基　　金：国家重点研发计划重大攻关项目(2017YFC1700601)——健脾活血方案治疗胃癌前病变临床循证评价及其疗效机制研究;中国中医科学院科技创新工程重大攻关项目(CI2021A01005)——胃黏膜“炎癌转化”不同病理阶段miRNA的筛选及其与虚实证候的相关性研究。

摘　　要：慢性胃炎(CG)是多种原因引起的胃黏膜慢性炎症或萎缩性病变。多因胃黏膜上皮遭受各种致病因素的反复侵害,基于黏膜特异的再生功能,使黏膜发生重建,最终导致不可逆的胃固有腺体的萎缩,甚至消失。现代研究表明胃黏膜慢性炎症长期浸润会引起细胞恶变,最终导致胃癌的发生,但其发生机制尚不明确。目前认为,在CG“炎-癌转化”的演变过程中,对胃黏膜萎缩的肠化生和异型增生等胃癌前病变的有效干预是胃癌二级预防的关键环节。中医学认为脾虚是CG“炎-癌转化”的重要病机,在此基础上受痰湿、瘀阻等因素的影响,可加速其恶变。恶变与线粒体能量代谢在微观表现及发生实质方面高度相关。Chronic gastritis(CG)is a chronic inflammation or atrophic lesion of gastric mucosa caused by various reasons.It is mostly due to the repeated invasion of gastric mucosal epithelium by various pathogenic factors,and the reconstruction of the mucosa due to its specific regeneration function,which eventually leads to the irreversible atrophy or even disappearance of the intrinsic glands of the stomach.Modern research shows that chronic inflammation of gastric mucosa can cause malignant changes in cells and eventually lead to the occurrence of gastric cancer,but its mechanism is still unclear.It is currently believed that effective intervention of precancerous lesions such as intestinal metaplasia and dysplasia in the background of gastric mucosal atrophy is the key link in secondary prevention of gastric cancer in CG“inflammation-cancer transformation”.In traditional Chinese medicine,spleen deficiency is an important pathogenesis of CG“inflammation-cancer transformation”,and on this basis,factors such as phlegm dampness and blood stasis can accelerate its malignant transformation process.This process is highly consistent with mitochondrial energy metabolism in terms of microscopic performance and occurrence.

关 键 词：慢性胃炎 “炎-癌转化” 线粒体 能量代谢 脾虚 病理产物 发病机制 防治 

分 类 号：R256[医药卫生—中医内科学] R259[医药卫生—中医学]