文献类型：期刊文献

中文题名：基于“扶正祛邪”探讨胃癌前病变的病机及防治思路

英文题名：Discussion on the pathogenesis and prevention of precancerous lesions of gastric cancer based on“Strengthening the body resistance to eliminate pathogenic factors”

作者：杨静[1];孙小伟[1];雷东旭[1];南青山[1];舒劲[2]

第一作者：杨静

机构：[1]甘肃中医药大学,甘肃兰州730000;[2]甘肃省中医院,甘肃兰州730000

第一机构：甘肃中医药大学

年份：2024

卷号：16

期号：6

起止页码：88

中文期刊名：中医临床研究

外文期刊名：Clinical Journal Of Chinese Medicine

基金：国家自然科学基金(82060860)。

语种：中文

中文关键词：扶正祛邪;胃癌前病变;病机;防治思路

外文关键词：“Strengthening the body resistance to eliminate pathogenic factors”;Precancerous lesions of gastric cancer;Pathogenesis;Pre-vention and treatment ideas

摘要：胃癌前病变(Precancerous Lesions of Gastric Cancer, PLGC)是指包括慢性萎缩性胃炎、肠上皮化生和异型增生的一种胃黏膜病理变化,是胃癌发生的重要阶段和炎-癌转化的“黄金转折点”。因此,及时、有效地截断或逆转PLGC对降低胃癌的发生率具有重要意义。扶正祛邪是中医治疗疾病的总纲和基本指导原则,即扶助衰弱之正气,祛逐强盛之邪气,以使正盛邪弱、正胜于邪、疾病向愈。PLGC归于中医的“胃痛”“痞满”等范畴,证候特征为“本虚标实、虚实夹杂”,其发生发展之根本为正衰与邪盛长期作用的结果,正衰(脾胃虚弱)为致病之本,贯穿疾病始终,是感邪和虚实夹杂的基础,反复感邪,出现不同的邪实(滞、痰、瘀、湿、热、毒等)为致病之标,为病理基础,多种邪实互为因果,致使疾病冗杂多变。邪盛与正衰共存于本病不同阶段,治疗应采用扶正祛邪原则,即“健脾益气、养阴益胃、温中散寒”以扶正与“理气、祛湿、除痰、化瘀、解毒”驱邪等治则,根据病机组合,动态施治。大量研究证实,中医中药在改善胃黏膜萎缩、逆转肠上皮化生和异型增生,显著改善临床症状及提高患者生存质量上具有一定优势和特色。文章基于“扶正祛邪”理论,从本质上探讨PLGC的病机及治疗思路,以更好的指导中医临床辨证施治。
Precancerous lesions of gastric cancer(PLGC)refers to a pathological change of gastric mucosa including chronic atrophic gastritis,intestinal metaplasia and dysplasia,which is an important stage in the development of gastric cancer and a“golden turning point”of ininflammator-cancer transformation.Therefore,timely and effective truncation or reversal of PLGC is of great significance in reducing the incidence of gastric cancer.“Strengthening the body resistance to eliminate pathogenic factors”is the general principle and basic guiding principle of TCM treatment of diseases,that is,to help the weak healthy Qi(气)and dispel the strong evil Qi,so that the healthy Qi prevails over evil Qi,which helps to heal the disease.PLGC belongs to the categories of“stomachache”and“fullness of stomach”in TCM,and the syndromes are characterized by“asthenia in origin and asthenia in superficiality,and deficiency mixed with excess”.The root of its occurrence and development is the result of the long-term decline of healthy Qi and excessive evil Qi.Healthy Qi deficiency(weakness of the spleen and stomach)is the root of the disease,which runs through the disease and is the basis of pathogenic factors and insufficiency mixed with excess.The appearance of different pathogenic factors(stagnation,phlegm,stasis,dampness,heat,poison,etc.)is the pathogenetic basis of disease,and a variety of pathogenic factors are mutually causes and effects,resulting in miscellaneous diseases.Pathogenic factors flourishing and healthy Qi declining coexist in different stages of the disease,the treatment should adopt the principle of strengthening the body resistance to eliminate pathogenic factors,that is,strengthening the body resistance means invigorating spleen and supplementing Qi,nourishing Yin(阴)and supplementing stomach,warming middlejiao(中焦)and dispelling cold,and eliminating pathogenic factors means regulating Qi,removing dampness,eliminating phlegm,removing blood stasis,and detoxifying.Combined with other therapeutic principles,dynamic treatment is given according to the pathogenesis.A large number of studies have confirmed that TCM has certain advantages and characteristics in improving gastric mucosa atrophy,it can reverse intestinal metaplasia and dysplasia,significantly relieve clinical symptoms and improve patients’quality of life.The paper probes into the pathogenesis and treatment of PLGC essentially based on the theory of“Strengthening the body resistance to eliminate pathogenic factors”,so as to better guide the clinical TCM differentiation and treatment.