基于“阳道实,阴道虚”理论探析慢性萎缩性胃炎“炎癌转化”的病因病机与防治思路

Analysis of Etiology,Pathogenesis,and Prevention and Treatment Strategies of Chronic Atrophic Gastritis with"Inflammation-cancer Transformation"Based on the Theory of"Yang often in Excess,while Yin in Deficiency"

基于“阳道实,阴道虚”理论分析慢性萎缩性胃炎(CAG)的病因病机和防治思路。在病因病机方面,脾属阴,脾病多虚,脾虚气血生化乏源。因虚生邪,形成病理产物,贯穿胃黏膜病变发生发展整个过程,故“阴道虚”是“炎癌转化”的根本。胃属阳,胃病多实。阳明经多气多血,久则入血入络成瘀。外邪如幽门螺杆菌(Hp)等犯胃,加之气机郁结等因素,诸邪阻胃,互相搏结,可见邪实的症状。炎症因子浸润发展,胃黏膜发生病理变化,故“阳道实”是“炎癌转化”的重要因素。在防治方面,针对“阴道虚”,虚者补之,从根本上补脾之虚;针对“阳道实”,实者泻之,在补脾之虚的基础上泻胃之实,化瘀、解毒、解郁,扶正祛邪,使阴阳调和,从而在一定程度上对CAG“炎癌转化”进行防治。

Based on the theory of“Yang often in Excess,while Yin in Deficiency”,this article analyzed the etiology,pathogenesis,and prevention and treatment strategies of chronic atrophic gastritis(CAG).In terms of etiology and pathogenesis,the spleen belongs to Yin,spleen diseases are often deficient,and spleen deficiency leads to dysfunction of Qi and blood conversion function.Due to deficiency,pathogenic factors are generated and pathological products are formed,which run through the whole process of the occurrence and development of gastric mucosal lesions.Therefore,"Yin in Deficiency"is the root of"inflammation-cancer transformation".The stomach belongs to Yang,stomach diseases are often excess.The Yangming meridian has too many Qi and blood,and after a long time,the blood enters the collaterals and formed stasis.External pathogens such as Helicobacter pylori(Hp)infection invade the stomach,combined with factors such as Qi stagnation and other factors,all of which block the stomach and fight against each other,indicating symptoms of excess of evil.Inflammatory factors infiltrate and develop,leading to pathological changes in the gastric mucosa.Therefore,"Yang often in Excess"is an important factor in"inflammation-cancer transformation".In terms of prevention and treatment,for the"Yin in Deficiency",the deficiency should be replenished,and the deficiency of spleen should be fundamentally replenished.For the"Yang often in Excess",the excess should treated by draining,and reducing the excess of stomach on the basis of reinforcing the deficiency of spleen.Removing blood stasis,detoxifying and relieving depression,strengthening the body and eliminating pathogenic factors,and balancing Yin and Yang,so as to prevent and treat the"Inflammation-cancer transformation"of CAG to a certain extent.