从脾论治胃癌前病变的思路与方法  

The Ideas and Methods of Treatment Related to the Spleen Theory on Precancerous Lesions of Gastric Carcinoma

作　　者：王涵 王萍[2] 王奕晨 唐旭东[3] WANG Han;WANG Ping;WANG Yichen;TANG Xudong(Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China;Xiyuan Hospital of China Academy of Chinese Medical Sciences,Bejing 100091,China;China Academy of Chinese Medical Sciences,Beijing 100700,China)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中国中医科学院西苑医院,北京100091 [3]中国中医科学院,北京1100700

出　　处：《世界科学技术-中医药现代化》2024年第3期634-639,共6页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：中国中医科学院西苑医院“提升高水平临床研究和成果转化能力试点建设项目”(XYZX0204-03):中医药防治胃癌前病变“炎-癌”转化关键环节的临床和基础研究,负责人:唐旭东;中国中医科学院科技创新工程创新团队(CI2021B005),负责人:唐旭东;北京市卫生健康委员会研究型病房建设项目(BCRW202108):慢性萎缩性胃炎、胃癌前病变预测模型及数据库建设,负责人:王萍。

摘　　要：胃癌前病变(Precancerous lesion of gastric carcinoma,PLGC)是胃粘膜“炎-癌转化”发生发展的重要环节。中医以整体调节、辨证论治的独特诊疗模式,在改善临床症状、提高生活质量、逆转病理组织学病变方面显示出良好优势。PLGC病位在脾胃,脾胃虚弱为其发病基础,脾胃运化失常、气机升降异常是症状发生的主要机制,由其演化而生的湿、痰、瘀、毒等胶结积聚久留促发局部病变。脾虚与PLGC发生发展的胃粘膜微环境失衡有关,涉及胃黏膜炎症、胃内菌群、胃黏膜屏障、免疫功能、能量代谢、黏膜分泌等机制。本文从脾入手思考PLGC的病机、治法、用药思路等,对统一认识、开拓临床和科研思路有参考意义。Precancerous lesion of gastric carcinoma(PLGC)is a critical component of the occurrence,development,and metastasis of the"inflammation-cancer transformation".Traditional Chinese medicine(TCM)is characterized by a unique mode of diagnosis and treatment which adopts a holistic concept to differentiate and treat syndromes.With this mode,it can improve symptoms in patients,enhance the quality of their lives and elevate the histopathological performance.The pathogenic factors of PLGC are mostly related to spleen,among which the weakness of spleen and stomach is the pathogenetic basis of it.Over time,dampness,phlegm and blood stasis will accumulate in the body,causing local lesions.Spleen deficiency is associated with various development mechanisms of PLGC,including the gastric mucosal inflammation,intragastric flora,gastric mucosal barrier,immune function,energy metabolism,and gastric mucosal secretion.To treat PLGC from the perspective of the spleen theory,physicians should take steps to reinforce healthy Qi to eliminate pathogenic factors,give equal consideration to deficiency and excess,and harmonize the center to restore the balance in the viscera,which will invigorate the spleen and stomach,resolve dampness,clear heat and regulate qi and blood at the same time.The differentiation of the holistic and local syndromes should be combined and the treatment with drugs should take both diseases and syndromes into consideration.

关 键 词：胃癌前病变 炎-癌转化 中医药 脾虚 

分 类 号：R735.2[医药卫生—肿瘤]