摘要
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。
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 malignant 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,symptoms view and precision view.(a)pre-disease view:early intervention to intercept inflammation-cancer transformation;(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 dissipating cold;(d)symptoms view:using herbal pairs to deal with the main symptoms;(e)precision view:enriching targets to prevent and control cancer directionally.
作者
葛媛莎
许博文
李杰
GE Yuansha;XU Bowen;LI Jie(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing,100053;Beijing University of Chinese Medicine)
出处
《中医杂志》
CSCD
北大核心
2024年第19期1988-1993,共6页
Journal of Traditional Chinese Medicine
基金
中国中医科学院科技创新工程重大攻关项目(CI2021A01802)
北京市重大疑难疾病中西医协同攻关项目(2023BJSZDYNJBXTGG-013)
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)(HLCMHPP2023001)
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)(HLCMHPP2023097)。
关键词
胃癌前病变
炎-癌转化
Correa演变
precancerous lesions of gastric cancer
inflammation-cancer transformation
Correa evolution
