从浊毒理论辨析胃“炎-癌转化”

An analysis of gastric“inflammation-cancer transformation”from the turbid toxin theory

慢性非可控性炎症在胃癌的产生、发展、恶化过程中发挥重要作用,炎症细胞和炎性介质的浸润构成了适宜肿瘤生长的炎性微环境,肿瘤侵袭、转移更离不开炎性微环境的持续存在,炎症与癌症两者之间关系密切。根据Correa模型,胃癌的发生常经历一个完整的炎-癌级联。在早期“炎-癌”转化阶段的中医药辨证施治可有效干预胃黏膜癌变的进程,中医药是胃癌及癌前病变治疗中不可或缺的部分。浊毒理论是李佃贵教授在古人对于浊与毒认识的基础上创新归纳而来的,李教授提出浊毒内蕴是胃“炎-癌转化”的核心病机,“浊为毒之渐,毒为浊之深”,“湿-浊-毒”是疾病病机发展的特点,与胃“炎-癌转化”特性具有相似之处。慢性炎症与“浊”密切相关,癌症与“毒”联系紧密,浊化、毒化反映出疾病病理状态的持续恶化,浊毒轻重往往可以预示疾病发展的规律。基于浊毒理论,从浊毒转化深入阐明胃“炎-癌”病机动态演变全过程,将化浊解毒法贯穿疾病治疗始终,施以精准分期治疗,以“扶正、健脾、化痰、散瘀”等治法使得浊化毒去、瘀除络通,进而达到减缓、阻断甚至逆转胃“炎-癌转化”进程的目的,以期为中医药干预胃“炎-癌转化”提供新思路。

Chronic non-resolving inflammation plays an exceedingly important role in the genesis,progression,and deterioration of gastric cancer.The infiltration of inflammatory cells and inflammatory mediators constitutes an inflammatory microenvironment conducive to tumor growth,and the continuous existence of inflammatory microenvironment is indispensable for tumor invasion and metastasis.There is a close relationship between inflammation and cancer.According to the Correa model,the development of gastric cancer typically follows a cascading process from inflammation to cancer.TCM treatment in the early stage of“inflammation-cancer”transformation can effectively intervene in the progression of gastric mucosal carcinogenesis,and TCM is an indispensable part of the treatment of gastric cancer and its precancerous lesions.The concept of turbid toxin theory,developed by Professor LI Diangui,is an innovative summarization based on ancient Chinese medical theories.Professor LI suggests that the internal accumulation of“turbidity”and“toxin”forms the core pathogenesis of the“inflammation-cancer transformation”in the stomach.This theory illustrates the interconnection between the concepts of“turbidity”signifying the gradual deterioration of disease status and“toxin”representing deeper-seated issues in diseases.Dampness-turbid-toxin bears similarities to the characteristics of the gastric“inflammation-cancer transformation.”Chronic inflammation is closely associated with“turbidity”,while cancer is intricately linked to“toxin”.This connection reflects the continuous worsening of the disease’s pathological condition.The degree of turbid toxin often predicts the developmental pattern of the disease.Based on turbid-toxin theory,the whole dynamic evolution process of gastric“inflammation-cancer”pathogenesis is further explained from turbid-toxin transformation.Turbid-detoxification method is the core throughout the disease,and precise stage treatment is carried out by“strengthening the body,tonifying the spleen,transforming phlegm,and dispersing stasis,”and other treatment methods,so as to remove turbid-toxin and blood stasis,thus achieving the purpose of slowing down,blocking or even reversing the process of gastric“inflammation-cancer transformation”with a prospect of providing new ideas for traditional Chinese medicine to intervene the transformation of stomach inflammation and cancer.