中医药干预慢性萎缩性胃炎“炎癌转化”研究进展

Research progress of traditional Chinese medicine intervention on"inflammatory cancer transformation"of chronic atrophic gastritis

慢性萎缩性胃炎(CAG)是一种难治性消化系统疾病,在此基础上伴发的肠上皮化生、异型增生/上皮内瘤变则视为癌前病变。CAG向胃癌的演变过程被认为是炎癌转化启动、发展及转归的主要环节,癌变的发生与CAG的严重程度呈正相关。积极干预CAG是胃癌防治的突破口。目前现代医学对CAG“炎癌转化”的发病机制尚不明确,亦缺乏理想的治疗手段。近年来,传统医学凭借多靶点、多通路的特点,在延缓、阻断甚至逆转CAG“炎癌转化”进程方面取得了显著进展,为临床治疗提供新的理论基础和新的防治思路。本文通过梳理相关文献,从病因病机及治疗机制着手,阐述中医药干预CAG“炎癌转化”的相关研究进展,以期为临床逆转胃癌前病变、降低胃癌发生率提供更多客观理论依据。

Chronic atrophic gastritis(CAG)is a refractory digestive system disease,and intestinal metaplasia,dysplasia/intraepithelial neoplasia secondary to CAG are regarded as precancerous lesions.The evolution of CAG to gastric cancer is considered to be the main link in the initiation,development and prognosis of inflammatory cancer transformation,and the occurrence of cancerization is positively related to the severity of CAG.Active intervention in CAG is a breakthrough in the prevention and treatment of gastric cancer.At present,the pathogenesis of CAG inflammatory cancer transformation has not been clarified in modern medicine,and there is no ideal treatment.In recent years,traditional Chinese medicine has made remarkable progress in delaying,blocking or even reversing the process of"inflammatory cancer transformation"of CAG,which provides a new theoretical basis and new prevention and treatment ideas for clinical treatment.By sorting the relevant literature,this paper expounds the research progress of traditional Chinese medicine intervention in"inflammatory cancer transformation"of CAG from the aspects of etiology,pathogenesis and treatment mechanism,in order to provide more objective theoretical basis for reversing gastric precancerous lesions in clinical practice and reducing the incidence of gastric cancer.