“胃黏膜肠化”的中医药临床治疗进展

Progress in clinical treatment of"intestinal metaplasia of gastric mucosa"with traditional Chinese medicine

“胃黏膜肠化”属胃癌前病变范畴,与胃癌发病相关,近年来的临床研究提示,中医药对其具有一定的疗效优势。本文就“胃黏膜肠化”的中医药临床治疗现状从辨证分型论治、辨证复方治疗、中成药剂治疗和针灸外治及其他方法治疗等方面进展进行综述,认为中医的辨证论治是目前治疗肠上皮化生(IM)的主导方法,并确有疗效;中医辨病复方和经验效方多为临床经验总结,已得到了广泛的临床应用;中成药对“肠化”的疗效作用、针灸外治的临床探索、药膳和情志调养的辅助作用亦得到了临床的关注和重视。本文针对“肠化”的临床研究设计、辨证分型客观标准的建立、治则方向、方药的选择和应用、中成药应用及针灸外治的客观评价等提出展望。

"Intestinal metaplasia of gastric mucosa"belongs to the category of precancerous lesions of gastric cancer and is related to the pathogenesis of gastric cancer.Recent clinical studies have shown that traditional Chinese medicine(TCM)exerts certain efficacy advantages.This paper reviews the current situation of TCM clinical treatment of"intestinal metaplasia of gastric mucosa"from the aspects:syndrome differentiationdependent treatment,Chinese medicine compound based on syndrome differentiation,treatment with Chinese patent medicine and external treatment of acupuncture and moxibustion,etc.It is considered that TCM syndrome differentiation-dependent treatment is the leading method for the treatment of intestinal metaplasia(IM).TCM disease identification compound prescriptions and experience prescriptions are mostly summarized from clinical experience,which have been widely used in clinical practice.The curative effect of Chinese patent medicine on"intestinal metaplasia",the clinical investigation of external treatment of acupuncture and moxibustion and the auxiliary effect of medicinal diet and emotional recuperation have also received clinical focus and attention.The paper also puts forward prospects for the clinical research design in terms of"intestinal metaplasia",the establishment of objective criteria for syndrome differentiation and classification,the direction of treatment,the selection and application of prescriptions,the application of Chinese patent medicine and the evaluation of external treatment of acupuncture and moxibustion.