从脾虚痰湿、瘀、毒论治胃癌前病变  

Treatment of Gastric Cancer Lesion from Perspective of Spleen Deficiency Induced Phlegm,Dampness,Stasis and Toxicity

作　　者：杨澜 刘俊保[1,2] YANG Lan;LIU Junbao(Henan University of Chinese Medicine,Zhengzhou Henan China 450046;Henan Provincial People′s Hospital,Zhengzhou Henan China 450003)

机构地区：[1]河南中医药大学,河南郑州450046 [2]河南省人民医院,河南郑州450003

出　　处：《中医学报》2024年第3期525-528,共4页Acta Chinese Medicine

基　　金：河南省中医药科学研究专项资助项目(2023ZY2198)。

摘　　要：胃癌前病变多因患者脾气亏虚,肾气不足,气血生化乏源,运化失常,阴液耗伤,湿蕴生痰,加之外邪侵袭,内生浊毒,久而致瘀,内外虚实合邪,复而继续损伤脾胃,形成本虚标实,虚实夹杂的复杂病机。治疗胃癌前病变应以扶正补虚为本,脾肾同治,气阴双补,使机体自身祛邪外出。补益脾气是治疗的基础,要贯穿治疗全过程。利湿祛痰化浊,抑制肿瘤微环境的生成,使其向正常环境转变是治疗的重要方向。化瘀解毒使内外毒邪排出体外,从而阻断癌变,是治疗的核心环节。故健脾益气、补肾滋阴、利湿祛痰、化瘀解毒是延缓胃癌前病变进程的基本治疗原则。Pre-cancerous lesions of gastric cancer are often caused by patients with Spleen Qi deficiency,insufficient Kidney Qi,lack of energy and blood biochemical sources,abnormal transportation and transformation,damage to Yin Fluid,accumulation of Dampness and Phlegm,invasion of external evil factors,internal generation of turbid Toxin and eventually leading to blood stasis.The combination of internal and external deficiency and excess can continue to damage the Spleen and Stomach,forming a complex pathogenesis of deficiency and excess,mixed with deficiency and excess.The treatment of precancerous lesions of gastric cancer should be based on nourishing the Zheng Qi and deficiency,treating both the Spleen and Kidney,supplementing both Qi and Yin,and promoting the body′s own powder in eliminating pathogenic factors.Tonifying the Spleen Qi is the foundation of treatment,which should run through the entire process of treatment.The important direction of treatment is to dispel Phlegm and Turbidity,to inhibit the formation of tumor microenvironment and transform it into a normal environment.The core of treatment is to eliminate internal and external toxins by removing blood stasis and detoxifying,thereby blocking cancer transformation.Therefore,the basic treatment principles for delaying the progression of precancerous lesions include strengthening the Spleen and tonifying Qi,tonifying the Kidney and nourishing Yin,removing Dampness,eliminating Phlegm as well as resolving blood stasis and detoxification.

关 键 词：胃癌前病变 脾虚痰湿 瘀 毒 健脾益气 补肾滋阴 利湿祛痰 化瘀解毒 

分 类 号：R273[医药卫生—中西医结合]