胃癌前病变(Precancerous lesion of gastric cancer,PLGC)是从正常胃黏膜向胃癌转化过程的一个重要阶段,具有病程长、难治愈的特点,慢性萎缩性胃炎(Chronic atrophic gastritis,CAG)伴胃黏膜病理肠上皮化生(Intestinal metaplasia,IM)是该阶段较常见的病理变化.现代研究表明,中医药对PLGC的黏膜萎缩和肠化生具有重要延缓作用,甚至可以逆转其进展."毒邪"贯穿于CAG病变之始终,文章基于"脾虚毒损胃络"假说,认为脾胃虚弱、痰湿瘀毒互结为CAG伴肠上皮化生的重要病机;从毒论治,将健脾解毒法用于慢性萎缩性胃炎伴肠上皮化生的防治,可为临床提供新的思路与方法.
Prevention and Treatment of Chronic Atrophic Gastritis with Intestinal Metaplasia Based on the Hypothesis of Spleen Deficiency and Poison Damage to the Gastric Collaterals
Precancerous lesion of gastric cancer(PLGC)is an important stage in the transformation process from normal gastric mu-cosa to gastric cancer,which has a long course and is difficult to cure.Chronic atrophic gastritis(CAG)accompanied by Intestinal metaplasia(IM)was the more common pathological change at this stage.Modern research has shown that Chinese medicine has an im-portant role in delaying mucosal atrophy and intestinal metaplasia in PLGC,and can even reverse its progression.Based on the hypoth-esis of spleen deficiency and toxin damage to the gastric collaterals,this paper suggests that spleen and stomach weakness,phlegm,dampness,stasis and toxin are the important pathogenesis of CAG with intestinal metaplasia.The application of spleen-invigorating detoxification method in the prevention and treatment of CAG with IM can provide a new idea and method for clinical treatment.
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