基于阴火理论探讨反流性食管炎“炎-癌”转化与中医药防治思路  

Discussion on"inflammation-cancer"transformation and prevention and treatment of TCM of reflux esophagitis based on the theory of Yin-fire

作　　者：严静 谢胜[2] 葛来安[3] 刘礼剑 黎丽群[2] 王光耀 李娟 韩冰洁 YAN Jing;XIE Sheng;GE Laian;LIU Lijian;LI Liqun;WANG Guangyao;LI Juan;HAN Bingjie(Graduate School of Guangxi University of Chinese Medicine,Nanning,530200,China;Department of Gastroenterology,the First Affiliated Hospital of Guangxi University of Chinese Medicine;Department of Gastroenterology,the Affiliated Hospital of Jiangxi University of Chinese Medicine)

机构地区：[1]广西中医药大学研究生院,南宁530200 [2]广西中医药大学第一附属医院脾胃病科 [3]江西中医药大学附属医院脾胃肝胆科

出　　处：《中国中西医结合消化杂志》2025年第3期320-325,共6页Chinese Journal of Integrated Traditional and Western Medicine on Digestion

基　　金：广西岐黄学者培养项目(No:2022015-003-01);国家自然科学基金地区基金项目(No:82260900,No:82160877);广西医疗卫生重点学科建设项目[No:桂卫科教发(20231)号];国家中医药管理局高水平中医药重点学科建设项目(No:zyyzdxk-2023167)。

摘　　要：反流性食管炎(reflux esophagitis,RE)是一种由胃内容物反流导致的慢性持续性食管炎症疾病。该病全球发病率呈不断上升趋势,现已被证实与食管癌(esophageal cancer,EC)的发生密切相关。长期存在的RE易诱发EC,严重威胁人类身心健康。“炎-癌”转化是炎症性疾病发展为癌症的转归动态总称,高度重视RE“炎-癌”转化对防治EC意义重大。本文基于李东垣的阴火理论,认为阴火产生的根本原因在于脾胃虚弱、元气不足。元气不足则阴火上乘,日久则成癌瘤,这是RE“炎-癌”转化的关键。本文从阴火理论出发,探讨RE“炎-癌”转化及其中医药防治思路,强调必须全面把握该病的动态变化,并针对其不同病理阶段进行辨证论治。主张以充养元气、清泻阴火、解毒祛邪治之,从而断阴火之源、折阴火之势和消阴火之积,最终延缓、阻断甚至逆转RE“炎-癌”转化过程,最大化发挥中医药的疗效。Reflux esophagitis(RE)is a chronic persistent esophageal inflammatory disease caused by reflux of gastric contents.The global incidence of the disease is on the rise,and it has been confirmed to be closely related to the occurrence of esophageal cancer(EC).Long-standing RE is easy to induce EC,which seriously threatens human physical and mental health."Inflammation-cancer"transformation is a general term for the development of inflammatory diseases into cancer.It is of great significance to attach great importance to and intervene in"inflammation-cancer"transformation for the prevention and treatment of EC.Based on theory of LI Dongyuan of Yin-fire,this paper holds that the root cause of Yin-fire lies in the weakness of spleen and stomach and the lack of vitality.The lack of vitality is superior to Yin-fire,and over time,it becomes a cancer tumor,which is the key of RE"inflammation-cancer"transformation.Based on the theory of Yin-fire,this paper discusses RE"inflammation-cancer"transformation and its prevention and treatment ideas of Chinese medicine,emphasizing that the dynamic changes of the disease must be fully grasped,and syndrome differentiation and treatment should be carried out for different pathological stages.It is advocated to treat RE by nourishing primordial Qi,clearing and purging Yin-fire,detoxifying and dispelling evil,so as to break the source of Yin-fire,fold the potential of Yin-fire and eliminate the accumulation of Yin-fire,and finally delay,block or even reverse the process of RE"inflammation-cancer"transformation,so as to maximize the efficacy of Chinese medicine.

关 键 词：阴火 反流性食管炎 食管癌 “炎-癌”转化 中医药 防治 

分 类 号：R256.3[医药卫生—中医内科学]