从“伏邪”论治胃癌前病变

Thoughts of syndrome differentiation and treatment of precancerous lesions of chronic atrophic gastritis based on the theory on hidden pathogen

胃癌前病变(PLGC)指在慢性萎缩性胃炎的基础上伴有肠上皮化生和异型增生的病理学改变, 也是胃黏膜发生"炎-癌转化"的重要病理环节, 重视PLGC的干预对胃癌二级预防具有重要的价值和意义。PLGC具有发病隐匿、化毒损络、缠绵难愈的特点, 与伏邪致病特点具有高度一致性。基于伏邪与PLGC发病的相关性, 从伏邪角度论治PLGC当以补中宫为主, 并结合理气化痰、祛瘀解毒等法逐邪外出, 同时注重预后调摄, 重视心身同治使邪无所复, 为从伏邪论治PLGC提供了新思路。

Precancerous lesions of gastric cancer(PLGC)is a pathological change accompanied by intestinal metaplasia and dysplasia on the basis of chronic atrophic gastritis.It is also an important stage of"inflammation-cancer transformation"on gastric mucosa.Paying attention to the intervention of PLGC has important value and significance for the secondary prevention of gastric cancer.PLGC has the characteristics of occult onset,toxin damaging collaterals,and long course of disease,which is highly consistent to the pathogenesis characteristics of incubative pathogenic factors.Based on the relevance of incubative pathogenic factors and PLGC,treatment of PLGC from the perspective of incubative pathogenic factors should be mainly strengthening the spleen and stomach,and combined with the methods of regulating qi and dissipating dampness,and removing blood stasis and detoxification.It should also pay attention to the prognosis.Paying attention to the body-mind treatment can reduce the re-occurrence,so as to provide a new way of thinking for treating PLGC from incubative pathogenic factors.