从“湿热伏邪”角度探讨胃癌的发生发展及中医辨治

Study on Occurrence and Development of Gastric Cancer and Treatment Based on“Latent Damp-Heat”

胃癌发生发展经历胃癌前病变、胃癌成瘤直至晚期复发转移,分析中医病机发现与湿热关系密切,并以此为线索展开深入探讨。根据湿热性质,分析其经历卫气营血的传变过程以及对气机、津液、血液的影响,阐释了湿热伏邪在胃癌发生发展不同时期的病理作用。根据中医理论及导师临证经验,提出在胃癌临床辨治中应分期侧重,胃癌前病变以健脾升清、降胃燥湿为重,成瘤期以清热化浊、化瘀祛痰,胃癌晚期以健脾温肾、搜剔通络为主,并根据患者个体差异进行灵活加减。重视气机调畅贯穿始终,以助运化水湿,防治湿热成形,祛邪外出。

Gastric cancer undergoes the periods of precancerous lesions,tumor formation and advanced cancer.By analyzing the pathogenesis of traditional Chinese medicine,it is found the development of gastric cancer has a close relationship with damp-heat.We analyzed the changes of damp-heat affecting functional activities of Qi,body fluid and blood in defensive-Qi-nutrient-blood phases.The paper explained the pathological effects of damp-heat in different stages of gastric cancer.According to the theory of traditional Chinese medicine and the experience of the tutor,it is proposed that the focus should be on the stages of gastric cancer.The treatment of gastric precancerous lesions is to strengthen the spleen,elevate Yang,harmonize stomach and eliminate dampness.In the stage of tumor formation,the treatment is to clear heat and turbidity,remove blood stasis and reduce phlegm.In the treatment of advanced gastric cancer,it is mainly to invigorate the spleen,warm the kidney and dredge channels.According to individual differences of patients,treatment methods should be flexibly changed.It should pay attention to the Qi movement throughout the operation to help to transport water and humidity as well as prevent damp-heat.