从“阳化气,阴成形”谈慢性萎缩性胃炎“炎癌转化”及防治

Discussion on "Yang Transforms Qi, Yin Forms Matter" in the Inflammation-to- Cancer Transformation of Chronic Atrophic Gastritis and Its Prevention and Treatment

胃癌是高发的消化系统肿瘤之一,致死率高。部分胃癌可由慢性萎缩性胃炎发展而来,慢性萎缩性胃炎是“炎-癌”转化发生的重要环节。目前西医对于慢性萎缩性胃炎的治疗以改善症状、祛除病因为主,尚无统一有效的治疗方案。“阳化气,阴成形”理论出自《素问·阴阳应象大论篇》,概括了阴阳的关系。阳主功能,能够产生清气和能量;阴主形态,能够产生各种有形物质。本文基于“阳化气,阴成形”理论,对慢性萎缩性胃炎“炎-癌”转化进行探讨,发现其发生、发展的核心机制为阳化气不足,阴成形太过,而癌变后的高代谢状态又可导致阳化气太过而阴成形不足。治疗方面应扶正补虚以培本、辨证祛邪以消阴、滋阴清热以制阳,恢复机体“阳化气,阴成形”动态平衡,阻止炎癌转化进程。

Gastric cancer is one of the most prevalent tumors of the digestive system,with a high mortality rate.Some cases of gastric cancer develop from chronic atrophic gastritis,which is a critical stage in the"inflammation-to-cancer"transformation.Currently,Western medicine focuses on symptom relief and elimination of causative factors for the treatment of chronic atrophic gastritis,but there is no unified and effective therapeutic approach.The theory of"Yang Transforms Qi,Yin Forms Matter,"from Suwen:Treatise on the Correspondence and Manifestation of Yin and Yang,summarizes the relationship between yin and yang.Yang governs function,generating clear qi and energy,while yin governs form,producing various tangible substances.Based on this theory,this paper has explored the inflammation-to-cancer transformation in chronic atrophic gastritis,and identified the core mechanism as insufficient yang transforming qi and excessive yin forming matter.The high metabolic state after cancer transformation can further lead to excessive yang transforming qi and insufficient yin forming matter.In terms of treatment,strengthening the body’s health qi,eliminating pathogenic factors based on syndrome differentiation,nourishing yin,and clearing heat to regulate yang are crucial to restoring the dynamic balance of“yang transforms qi,yin forms matter”and preventing the progression of inflammation to cancer.