近10年中医辨治胃癌前病变的研究进展  

Research Progress in the Differentiation and Treatment of Precancerous Lesions of Gastric Cancer with Traditional Chinese Medicine in Recent 10 Years

作　　者：徐思中 刘嘉琪 李韵然 赵奕 XU Si-Zhong;LIU Jia-Qi;LI Yun-Ran;ZHAO Yi(Clinical Medical School of Traditional Chinese and Western Medicine,Guangzhou Medical University,Guangzhou 511436 Guangdong,China;The Affiliated Traditional Chinese Medicine Hospital of Guangzhou Medical University,Guangzhou 510130 Guangdong,China)

机构地区：[1]广州医科大学中西医临床学院,广东广州511436 [2]广州医科大学附属中医医院,广东广州510130

出　　处：《广州中医药大学学报》2024年第8期2219-2224,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20231253);广州市科技厅科研项目(编号:SL2022A03J00189)。

摘　　要：对近10年来有关中医辨治胃癌前病变(precancerous lesions of gastric cancer,PLGC)的研究进行综述。PLGC是指在慢性萎缩性胃炎基础上出现的胃黏膜肠上皮化生和异型增生,作为慢性萎缩性胃炎与胃癌的中间阶段,PLGC的病程较缓慢。中医辨治PLGC具有一定的优势。PLGC主要可分为脾胃虚弱证、脾胃湿热证、肝胃气滞证、胃络瘀阻证、胃阴不足证5种证型。胃镜技术的普及促进了胃病微观辨证的发展,微观辨证与宏观辨证的结合为PLGC的中医辨证论治提供了更加丰富的理论支持。PLGC根本病机为脾胃虚弱,脾胃气机不畅,兼有湿热、瘀毒、痰湿等病理因素蕴结,日久胃阴亏耗。中药治疗PLGC的临床研究开展较多,治疗主要采用以益气健脾为主,兼以疏肝活血、化湿消瘀、化瘀解毒、养阴益胃,从而防止PLGC向胃癌进一步发展。针灸治疗胃癌前病变的研究开展较少。今后需开展更多严格且规范的多中心、大样本的临床随机对照试验,深入研究针灸治疗胃癌前病变机制,以期为中医辨治PLGC提供更多高级别的循证依据。This paper reviewed the research progress in the differentiation and treatment of precancerous lesions of gastric cancer(PLGC)with traditional Chinese medicine(TCM)in the recent 10 years.PLGC refers to the intestinal metaplasia and dysplasia of gastric mucosa developed from chronic atrophic gastritis.As an intermediate stage between chronic atrophic gastritis and gastric cancer,PLGC progresses slowly.TCM has certain advantages in the treatment of PLGC.PLGC can be mainly differentiated as five TCM syndrome types:spleen-stomach weakness syndrome,damp-heat in the spleen and stomach syndrome,qi stagnation in the liver and stomach syndrome,stasis obstruction in the stomach collateral syndrome,and stomach-yin deficiency syndrome.The popularization of gastroscopy technology has promoted the development of microscopic syndrome differentiation of gastric diseases.The combination of microscopic syndrome differentiation and macroscopic syndrome differentiation provides more theoretical supports for the TCM syndrome differentiation and treatment of PLGC.The basic pathogenesis of PLGC is due to the weakness of spleen and stomach and the disordered qi movement in the spleen and stomach,complicated by the accumulation of pathological factors such as damp-heat,stasis-toxin,phlegm-damp,and then the stomach-yin will be consumed over time.An amount of clinical studies on the treatment of PLGC with Chinese medicine have been carried out in recent years.The Chinese medicine treatment of PLGC is mainly through benefiting qi and invigorating spleen,assisted by the methods of soothing liver and activating blood,resolving dampness and eliminating stasis,resolving stasis and removing toxins,and nourishing yin and benefiting stomach,so as to prevent the PLGC progressing to gastric cancer.There are few studies on acupuncture treatment of precancerous lesions of gastric cancer.Therefore,it is necessary to carry out more strict and standardized multicenter large-sample RCTs,and to further study the therapeutic mechanism of acupuncture and mox

关 键 词：胃癌前病变 慢性萎缩性胃炎 微观辨证 益气健脾 疏肝活血 化湿消瘀 化瘀解毒 养阴益胃 针灸 

分 类 号：R273[医药卫生—中西医结合]