首页|基于"五观辨治"体系论治胃"炎-癌"转化

基于"五观辨治"体系论治胃"炎-癌"转化

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规范化胃镜筛查使胃癌前病变(PLGC)的诊断更加明确,Correa演变是胃炎-癌转化的关键,提示PLGC是机体由正常转向癌变的核心.基于恶性肿瘤"五观辨治"体系中未病观、时空观、核心观、症状观、精准观五个维度探索建立防治良性、炎性病变恶性转化的新体系,即:1)未病观:尽早干预截断炎-癌转化.2)时空观:遵循疾病进展时空构架.3)核心观:挈领炎-癌转化核心病机.在分期方面,早期气虚郁滞,治以益气解郁,中期阴浊内壅,治以温阳化浊,癌变期癌毒瘀阻,治以抗癌解毒化瘀;在病位方面,上部者理气化痰、引而越之,中部者养阴清热、泻之于内,下部者行气散寒、引而竭之.4)症状观:活用药对解决主要症状;5)精准观:富集靶标定向防控癌变.
Discussion on Treatment of Gastric"Inflammation-cancer"Transformation based on the"Five-view Differentiation and Treatment"System
Standardized gastroscopy screening makes the diagnosis of precancerous lesions of gastric cancer(PLGC)clearer.Correa evolution is the key to gastritis-cancer transformation,suggesting that PLGC is the core of the body's transformation from normal to cancer.Based on the"five-view differentiation and treatment"system for malig-nant tumors,we explored the establishment of a new system for preventing and treating malignant transformation of benign and inflammatory lesions from five dimensions,including pre-disease view,time-space view,core view,symp-toms view and precision view.(a)pre-disease view:early intervention to intercept inflammation-cancer transforma-tion;(b)time-space view:following the time-space framework as the disease progresses;(c)core view:focusing on the core pathogenesis of inflammation-cancer transformation.In terms of different stages,qi deficiency and stagnation are mainly manifested in the early stage,which can be treated by invigorating qi and resolving constraint;in the middle stage,yin turbidity is blocked internally,and it can be treated by warming yang and removing turbidity;in the cancerous stage,cancer toxin are blocked,for which the anti-cancer,toxins-resolving and stasis-dissolving method is suggested.In terms of the location of the disease,it is suggested to relieve disease in the upper body by rectifying qi and dissolving phlegm with emetic therapy(vomit induction);for the disease in the middle,it it suggested to nourish yin and clear heat by elimination method;pathogen in the lower requires dredging method by moving qi and dissipat-ing cold;(d)symptoms view:using herbal pairs to deal with the main symptoms;(e)precision view:enriching targets to prevent and control cancer directionally.

precancerous lesions of gastric cancerinflammation-cancer transformationCorrea evolution

葛媛莎、许博文、李杰

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中国中医科学院广安门医院,北京市西城区北线阁5号,100053

北京中医药大学

胃癌前病变 炎-癌转化 Correa演变

中国中医科学院科技创新工程重大攻关项目北京市重大疑难疾病中西医协同攻关项目中央高水平中医医院临床研究和成果转化能力提升项目-临床科研一体化人才专项(创新团队培育项目)中央高水平中医医院临床研究和成果转化能力提升项目-临床科研一体化人才专项(领军人才培育项目)

CI2021A018022023BJSZDYNJBXTGG-013HLCMHPP2023001HLCMHPP2023097

2024

10.13288/j.11-2166/r.2024.19.007

中医杂志
中华中医药学会 中国中医科学院

中医杂志

CSTPCD北大核心
影响因子：1.464
ISSN：1001-1668
年,卷(期)：2024.65(19)