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基于时空观精准辨治胃癌前病变

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胃癌前病变(GPL)是一类容易进展为胃癌的黏膜病理组织学病变,目前尚无公认有效的治疗方案推荐.中医治疗本病具有独特优势,能够改善症状、逆转病变和延缓疾病进展.中国精准医疗计划于2016年启动,近年愈来愈多提倡中医药精准医疗.时昭红教授提出基于时空观的GPL精准辨治模式,在时间维度上,将疾病发展阶段证候特点从虚实两端精准分期而治;依据"四时五脏阴阳"不同精准用药,同时预见性辨证用药,精准防止疾病进展.在空间维度上,结合地域环境、体质个体化施治,并结合内镜技术与病理从内部与微观层面精准辨证论治,延伸了中医望诊与辨证的内涵,为GPL临床辨治提供了更加动态而全面的参考.
Precision diagnosis and treatment of gastric precancerous lesions based on space-time view
Gastric precancerous lesions(GPL)are a category of mucosal histopathological changes that can progress to gastric cancer.Currently,there is no universally accepted effective treatment recommendation for GPL.Traditional Chinese medicine(TCM)offers distinct advantages in treating this condition,including symptom improvement,lesion reversal,and slowing disease progression.The China Precision Medicine Initiative,launched in 2016,has increasingly emphasized TCM-based precision medicine in recent years.Professor Shi Zhaohong has proposed a precise diagnosis and treatment model for GPL based on a space-time view.In the temporal dimension of disease development,treatments are precisely differentiated for deficiency stage and excess stage.Based on the principles of"The Interplay of the Five Zang Organs and Yin-Yang Throughout the Four Seasons",precise herbal medicine is offered,along with anticipatory individualized treatment to prevent disease progression.In the spatial dimension,personalized treatment is realized by combining regional environmental factors and physique constitu-tion,and endoscopic techniques and pathology are used for precise diagnosis and treatment at the internal and mi-croscopic levels.This approach extends the scope of TCM inspection technique and syndrome differentiation,of-fering a more dynamic and comprehensive reference for the clinical management of GPL.

gastric precancerous lesionsprecision medicinespace-time viewtraditional Chinese medicine

张书、时昭红、李双翼、张曼玲、杜念龙、刘凡

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华中科技大学同济医学院附属武汉中西医结合医院消化内科(武汉,430022)

湖北中医药大学

胃癌前病变 精准医疗 时空观 中医药

国家重点研发计划湖北省中医药重点学科建设项目

2017YFC1700601鄂中医通[2023]2号

2024

中国中西医结合消化杂志
华中科技大学同济医学院,中国中西医结合学会消化系统疾病专业委员会,中华中医药学会脾胃病专业委员会

中国中西医结合消化杂志

CSTPCD
影响因子:1.363
ISSN:1671-038X
年,卷(期):2024.32(7)