| 傅宇斐,胥刘一,胡雪琴,等.从气津血探讨胃“炎-癌”转化全周期病机演变[J].浙江中医药大学学报,2025,49(2):141-145. |
| 从气津血探讨胃“炎-癌”转化全周期病机演变 |
| Complete Period Pathogenesis of Gastric “Inflammation-Cancer” Transformation Discussed from Qi， Fluid and Blood |
| DOI：10.16466/j.issn1005-5509.2025.02.003 |
| 中文关键词: 胃“炎-癌”转化 胃癌前病变 慢性萎缩性胃炎 气津血 瘀毒互结 调气养阴活血 化瘀解毒 全周期 |
| 英文关键词: gastric “inflammation-cancer” transformation gastric pre-cancerosis chronic atrophic gastritis Qi, body fluid and blood stasis-toxin blockage regulating Qi , tonifying Yin and activating blood circulation resolving stasis and removing toxins complete period |
| 基金项目:国家自然科学基金重点项目(82030119)；浙江省自然科学基金探索一般项目(LY22H290005) |
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| 中文摘要: |
| [目的] 从《黄帝内经》气、津、血三者关系出发，探讨胃“炎-癌”转化全周期病机演变过程，为干预胃“炎-癌”转化提供新的思路。[方法] 通过对《黄帝内经》《金匮要略》《诸病源候论》《临证指南医案》《医林改错》等医籍进行文献梳理，对胃“炎-癌”转化全周期病机演变进行探析；针对胃“炎-癌”转化不同阶段，总结现代医家中医治疗方案。[结果] 肝郁气滞、津液不足诱发慢性萎缩性胃炎，中气不足、津亏血瘀、瘀久蕴毒、瘀毒互结是胃“炎-癌”转化的关键病机。干预胃“炎-癌”转化过程早期需强调疏肝理气，中期以益气健脾为主，中晚期强调养阴活血，末期以益气化瘀解毒为重。[结论] 气津血互累的病机要素在胃“炎-癌”转化全周期演变中发挥重要作用。调气养阴活血、化瘀解毒是治疗胃癌前病变的基本方法，且在临床中取得较好疗效。 |
| 英文摘要: |
| [Objective] Based on the relationship of Qi， fluid and blood in the Huangdi Neijing， to explore the basic pathogenesis of gastric “inflammation-cancer” transformation， also provide new ideas for the prevention and treatment of gastric cancer and inhibition of gastric “inflammation-cancer” transformation. [Methods] This paper analyzes the evolution of the pathogenesis of the whole cycle of gastric “inflammation-cancer” transformation with the analysis of Huangdi Neijing， Synopsis of the Golden Chamber， General Treatise on the Cause and Symptoms of Diseases and others. It also summarizes the traditional Chinese medical treatment options of modern medical practitioners for different stages of gastric “inflammation-cancer” transformation. [Results] Chronic atrophic gastritis is induced by liver Qi stagnation， spleen-stomach weakness and insufficient fluid over a long period of time. Lacking vital energy， deficiency of fluid and blood stasis， prolonged accumulation of venom， body fluid blocked-blood stasis， stasis-toxin blockage are the key pathogenic mechanisms of gastric “inflammation-cancer” transformation. To intervene in the process of gastric “inflammation-cancer” transformation， it is necessary to emphasize the simultaneous treatment of Qi， fluid and blood. Intervention in the transformation process of gastric “inflammation-cancer” should emphasize on dredging the liver and regulating the Qi in the early stage， benefiting the Qi and strengthening the spleen in the middle stage， nourishing the Yin and activating the blood in the middle and late stages， and benefiting the Qi and resolving the blood stasis and detoxification in the final stage. [Conclusion] The pathogenetic elements of poor Qi， fluid blocked-blood stasis， stasis-toxin blockage play an important role in the evolution of the whole cycle of gastric “inflammation-cancer” transformation. Regulating Qi，tonifying Yin and activating blood circulation， resolving stasis and removing toxins are the basic methods for treating gastric precancerous lesions， and they have achieved good therapeutic effects in clinical practice. |
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