摘要
胃癌前病变是胃黏膜癌变进程中的关键阶段,其病理演变遵循“正常胃黏膜→浅表性胃炎→慢性萎缩性胃炎→肠上皮化生→异型增生→胃癌”的规律,临床具有起病隐匿、进展缓慢且癌变风险高的特点,目前,现代医学治疗难以有效逆转腺体萎缩及肠化。中医学认为,胃癌前病变属于“胃痞”“胃脘痛”等范畴,其病机本质为虚实夹杂,这与“虚气留滞”理论不谋而合。“虚气”以脾肾二脏虚弱为本,脾胃气虚致气血生化乏源、胃黏膜失养,肾气不足则失于温煦濡养,二者共同导致气血津液运行障碍;“留滞”则表现为痰湿、瘀血、毒邪等病理产物蕴结胃络,既是“虚气”的病理结果,又可进一步耗伤正气,形成“虚-滞”恶性循环,推动病情进展。治疗上应遵循“补虚通滞”原则,以健脾益胃、固护肾气为基础,结合化痰祛湿、活血化瘀、解毒通络、疏肝理气四联“通滞”,清除病理产物,多靶点干预,调节免疫微环境、改善胃黏膜血供、逆转病理改变,体现中医“既病防变”的防治思想。文章系统梳理了“虚气留滞”理论源流,深入探讨其在胃癌前病变病机演变中的指导意义,并结合验案分析,为中医药防治胃癌前病变提供理论依据与临床思路。
Precancerous lesions of gastric cancer(PLGC),a critical stage in gastric carcinogenesis,are regarded in traditional Chinese medicine(TCM)as a complex syndrome of deficiency-excess complexity,which aligns with the theory of"deficiency-Qi(气)stagnation."The"deficiency"aspect stems from the weakness of the spleen and kidneys,while the"stagnation"presents as the accumulation of phlegm-dampness,blood stasis,and toxic pathogens.These factors interact synergistically,driving disease progression.Therapeutic strategies emphasize"tonifying deficiency and resolving stagnation,"focusing on strengthening the spleen and stomach,consolidating kidney Qi,and supplementing with methods to resolve phlegm-dampness,activate blood circulation,and detoxify.This study explores the pathogenesis and treatment of PLGC under the framework of"deficiency-Qi stagnation,"aiming to provide novel insights for clinical practice.
出处
《中医临床研究》
2025年第33期19-24,共6页
Clinical Journal Of Chinese Medicine
关键词
虚气留滞
胃癌前病变
脾肾虚弱
痰瘀毒
Deficiency-Qi stagnation
Precancerous lesions of gastric cancer
Spleen kidney deficiency
Phlegm-stasis-toxin
