胃癌高发区应用中药复方防治的关键机制和智能诊疗模式研究  

Key Mechanisms and Intelligent Diagnosis and Treatment Models of the Application of Chinese Medicine Compound Formulas in High-incidence Areas of Gastric Cancer for Prevention and Treatment

作　　者：徐伟超[1,2] 李博林 娄莹莹[1,2] 才艳茹 杜朋丽[1,2] 孙建慧 张乃霖 刘阳 郭硕 张坤 郎晓猛 白海燕[1,2,5] 杜艳茹[1,2,6] 支政[1,2] 刘韦辰 杨倩[1,2,5] XU Weichao;LI Bolin;LOU Yingying;CAI Yanru;DU Pengli;SUN Jianhui;ZHANG Nailin;LIU Yang;GUO Shuo;ZHANG Kun;LANG Xiaomeng;BAI Haiyan;DU Yanru;ZHI Zheng;LIU Weichen;YANG Qian(Hebei Provincial Hospital of Traditional Chinese Medicine,Shijiazhuang 050091,China;Graduate School of Hebei University of Chinese Medicine,Shijiazhuang 050000,China;Hebei Cancer Hospital,Shijiazhuang 050000,China;School of Information Science and Engineering,Hebei University of Science and Technology,Shijiazhuang 050000,China;Key Laboratory of Turbidity and Toxicity Syndrome in Hebei Province,Shijiazhuang 050000,China;Key Laboratory of Integrated Traditional Chinese and Western Medicine Gastrointestinal Disease Research in Hebei Province,Shijiazhuang 050000,China;College of Computing and Data Science,Nanyang Technological University,Singapore 639798)

机构地区：[1]河北省中医院,石家庄050091 [2]河北中医药大学研究生学院,石家庄050000 [3]河北省肿瘤医院,石家庄050000 [4]河北科技大学信息科学与工程学院,石家庄050000 [5]河北省浊毒证重点实验室,石家庄050000 [6]河北省中西医结合胃肠病研究重点实验室,石家庄050000 [7]新加坡南洋理工大学计算机与数据科学学院,新加坡639798

出　　处：《世界中医药》2024年第22期3542-3547,3554,共7页World Chinese Medicine

基　　金：国家自然科学基金项目(82205314);国家中医药管理局第七批全国老中医药专家学术经验继承项目(国中医药人教函〔2022〕76号);中华中医药学会脾胃病分会青年培英计划项目(中会学术〔2025〕2号);河北省省级科技计划资助项目(246W7701D);河北省“岐黄赤子”培养工程(冀中医药函〔2025〕1号);河北省“三三三人才工程”资助项目(C20231017);河北省高等教育教学改革研究与实践项目(2023GJJG287)。

摘　　要：胃癌(GC)是我国发病率和死亡率居第二位的恶性肿瘤,其发生过程遵循“萎缩性胃炎-肠上皮化生/上皮内瘤变-胃癌”的“炎-癌”转化规律。中医浊毒理论是新时期中医理论创新的典型代表,对“炎-癌”转化病机有新认识,浊毒致病可上调炎症介质水平,化浊解毒法及其代表方剂香连化浊方通过调节胃内微环境、抑制细胞增殖和促进细胞凋亡,有效阻断“炎-癌”转化。多组学分析揭示了胃内微环境的复杂变化,包括代谢物、菌群和免疫功能的紊乱。借助Transformer和Vision Transformer(ViT)等深度学习技术,采集胃癌高发区慢性萎缩性胃炎大样本临床病例,分析癌前病变的中西医诊疗多模态、多组学大数据,聚焦“胃内微环境”概念,选取“炎-癌”转化标志物,建立一个胃癌早期智能预警模型,创新中医药防治胃癌的智能诊疗模式;阐释中医药在癌前病变的病证防治、阻断“炎-癌”转化等方面的关键机制,揭示方剂核心成分和作用靶点,为降低胃癌发病率、解读病证诊断科学内涵和智能诊疗传承创新提供理论借鉴和研发启示。通过“数字化发现+定量化验证+智能化应用”方式,实现中医理论指导下,实验基础研究与产品转化研究的双向互动,形成多学科知识关系服务中医特色优势病种现代防控的路径与范式。Gastric cancer(GC)is the second most common malignancy in terms of incidence and mortality in China.Its development follows the“inflammatory atrophic gastritis-intestinal metaplasia/intraepithelial neoplasia-gastric cancer”progression,illustrating the“inflammation-cancer”transformation pattern.The traditional Chinese medicine(TCM)theory of“turbidity-toxin”is a typical innovation in modern TCM theory and provides a new understanding of the pathogenesis of the“inflammation-cancer”transformation.Turbidity-toxins can upregulate the levels of inflammatory mediators,and the method of resolving turbidity and removing toxins,represented by the formula Xianglian Huazhuo Formula,effectively blocks the“inflammation-cancer”transformation by regulating the gastric microenvironment,inhibiting cell proliferation,and promoting apoptosis.Multi-omics analysis reveals the complex changes in the gastric microenvironment,including disturbances in metabolites,microbiota,and immune function.Using deep learning technologies such as Transformer and Vision Transformer(ViT),large-scale clinical cases from high-incidence areas of chronic atrophic gastritis are collected to analyze multimodal,multi-omics big data of precancerous lesions from both TCM and Western medicine perspectives.This research focuses on the concept of“gastric microenvironment”,selects biomarkers for the“inflammation-cancer”transformation,and establishes an early warning model for gastric cancer.It aims to innovate an intelligent diagnosis and treatment model for gastric cancer prevention and treatment using TCM.This study elucidates the key mechanisms of TCM in the disease-syndrome prevention and treatment of precancerous lesions,blocking the“inflammation-cancer”transition,and reveals the core components and targets of TCM formulas,providing theoretical insights and research inspiration for reducing gastric cancer incidence,interpreting the scientific connotation of disease-syndrome diagnosis,and inheriting and innovating intelligent diag

关 键 词：胃癌 中医药 中药复方 防治 关键机制 智能诊疗 癌前病变 “炎-癌”转化 

分 类 号：R256.3[医药卫生—中医内科学] R735.2[医药卫生—中医学]