Discuss the differentiation and treatment of chronic atrophic gastritis from the theory of "Jueyin-Shaoyang rejuvenation"
-
摘要: 慢性萎缩性胃炎(chronic atrophic gastritis，CAG)是一种腺体萎缩或伴发肠上皮增生性癌前病变，因其病程长、难逆转、易癌变等特点已成为消化系统难治性疾病。临证可基于“厥阴-少阳复化”理论，梳理厥阴少阳与相火源成、流布的关系，探析CAG的分期辨治。相火源起厥阴肝木，经各脏气化流转敷布于少阳三焦，结合CAG各期病理特点，认为CAG活动性炎症期病机为相火妄攻、湿热熏蒸，当清泻少阳、敛降相火；CAG腺体萎缩期病机为相火消烁、渐转太阴，当治守太阴、辛开苦降；CAG肠化增生期病机为内逆厥阴、化为异火，当遵厥阴复化、寒温并举的治疗法则。临证强调阴阳承转、促火复化以截断CAG的病理演变进程，为中医分期辨治CAG提供新的理论指导。Abstract: Chronic atrophic gastritis(CAG) is a precancerous lesion with glandular atrophy or intestinal epithelial hyperplasia, which has become a difficult disease of the digestive system due to its long course, difficulty in reversal, and susceptibility to carcinogenesis. The clinical evidence can be based on the theory of "Jueyin-Shaoyang rejuvenation", sorting out the relationship between Jueyin-Shaoyang and the origin and distribution of phase fire, and exploring the staging and treatment of CAG. The pathological characteristics of each stage of CAG are combined to suggest that the pathological mechanism of active inflammation stage of CAG is the attack of phase fire and the fumigation of damp-heat, so we should clear Shaoyang and subdue phase fire. In the stage of CAG intestinal hyperplasia, the disease mechanism is internal rebellion against the Jueyin, which turns into foreign fire. The clinical evidence emphasizes the transfer of Yin and Yang and the promotion of fire rejuvenation to interrupt the pathological evolution of CAG, which provides new theoretical guidance for the staged treatment of CAG in Chinese Medicine.
-
Key words:
- Jueyin /
- Shaoyang /
- rejuvenation /
- chronic atrophic gastritis
-
-
[1] Yang H, Yang WJ, Hu B. Gastric epithelial histology and precancerous conditions[J]. World J Gastrointest Oncol, 2022, 14(2): 396-412. doi: 10.4251/wjgo.v14.i2.396
[2] Annibale B, Esposito G, Lahner E. A current clinical overview of atrophic gastritis[J]. Expert Rev Gastroenterol Hepatol, 2020, 14(2): 93-102. doi: 10.1080/17474124.2020.1718491
[3] 刘伟, 倪家慧, 张丹, 等. 中医药调控胃"炎癌转化"癌前微环境的思考与策略[J]. 中华中医药杂志, 2023, 38(4): 1431-1435. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202304005.htm
[4] 曹阳, 顾巍杰, 杨德才, 等. 基于临床流调的慢性萎缩性胃炎发病危险因素研究[J]. 世界科学技术-中医药现代化, 2020, 22(4): 1060-1067. https://www.cnki.com.cn/Article/CJFDTOTAL-SJKX202004023.htm
[5] Shah SC, Piazuelo MB, Kuipers EJ, et al. AGA clinical practice update on the diagnosis and management of atrophic gastritis: expert review[J]. Gastroenterology, 2021, 161(4): 1325-1332. e7. doi: 10.1053/j.gastro.2021.06.078
[6] Zheng SY, Zhu L, Wu LY, et al. Helicobacter pylori-positive chronic atrophic gastritis and cellular senescence[J]. Helicobacter, 2023, 28(1): e12944. doi: 10.1111/hel.12944
[7] 李军祥, 陈誩, 吕宾, 等. 慢性萎缩性胃炎中西医结合诊疗共识意见(2017年)[J]. 中国中西医结合消化杂志, 2018, 26(2): 121-131. https://zxyxh.whuhzzs.com/article/doi/10.3969/j.issn.1671-038X.2018.02.03
[8] 梁国英, 曲智慧, 李庆伟. 慢性萎缩性胃炎致病因素的中西医研究进展[J]. 中国中西医结合消化杂志, 2022, 30(5): 378-382. https://zxyxh.whuhzzs.com/article/doi/10.3969/j.issn.1671-038X.2022.05.15
[9] 罗慧, 唐梅文, 农复香, 等. 中医药防治慢性萎缩性胃炎癌变作用机制研究进展[J]. 陕西中医, 2023, 44(2): 267-270. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZY202302030.htm
[10] Rugge M, Savarino E, Sbaraglia M, et al. Gastritis: the clinico-pathological spectrum[J]. Dig Liver Dis, 2021, 53(10): 1237-1246. doi: 10.1016/j.dld.2021.03.007
[11] Oronsky B, Caroen S, Reid T. What exactly is inflammation(and what is it not?)[J]. Int J Mol Sci, 2022, 23(23): 14905. doi: 10.3390/ijms232314905
[12] Dhingra AK, Chopra B. Inflammation as a therapeutic target for various deadly disorders: a review[J]. Curr Drug Targets, 2020, 21(6): 582-588. doi: 10.2174/1389450120666191204154115
[13] 王少丽, 白宇宁, 倪媛元, 等. 慢性萎缩性胃炎中医证候分布与胃黏膜病理变化的相关性研究[J]. 中国中医基础医学杂志, 2021, 27(4): 603-607. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYJC202104021.htm
[14] Yang H, Zhou X, Hu B. The reversibility' of chronic atrophic gastritis after the eradication of Helicobacter pylori[J]. Postgrad Med, 2022, 134(5): 474-479. doi: 10.1080/00325481.2022.2063604
[15] 蒙仕祥, 陈卜伟, 冯永锋. 香茶花芽汤对脾胃虚弱型慢性萎缩性胃炎疗效及异型增生、腺体萎缩的改善研究[J]. 中华中医药学刊, 2023, 41(3): 96-99. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS202303021.htm
[16] 徐晴, 王萍, 姜艾利, 等. 从脾虚论治慢性萎缩性胃炎及胃癌前病变的思考[J]. 中华中医药学刊, 2021, 39(8): 186-188. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS202108045.htm
[17] Cheng ML, Nakib D, Perciani CT, et al. The immune niche of the liver[J]. Clin Sci(Lond), 2021, 135(20): 2445-2466.
[18] Tilg H, Adolph TE, Trauner M. Gut-liver axis: Pathophysiological concepts and clinical implications[J]. Cell Metab, 2022, 34(11): 1700-1718.
[19] 李星慧, 王章林, 夏淑洁, 等. 慢性萎缩性胃炎证素分布特征[J]. 中华中医药杂志, 2023, 38(6): 2828-2831. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202306076.htm
[20] 张华峰, 魏星, 张杨. 健脾益气法治疗慢性萎缩性胃炎机制研究进展[J]. 陕西中医, 2023, 44(6): 808-810. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZY202306028.htm
[21] 朱景茹, 黄婉仪, 杨宗保, 等. 柴芍六君汤对慢性萎缩性胃炎肝郁脾虚证模型大鼠胃黏膜组织NF-κB、c-Myc、STAT1表达的影响[J]. 中医杂志, 2021, 62(11): 984-989. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ202111014.htm
[22] 李灵, 陈健, 张梁坤, 等. 基于Wnt/β-catenin信号通路以半夏泻心汤治疗慢性萎缩性胃炎探究寒热错杂证病机本质[J]. 中华中医药杂志, 2022, 37(5): 2947-2951. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202205098.htm
[23] 徐楚楚, 罗梦雪, 方霜霜, 等. 基于网络药理学探讨半夏泻心汤"异病同治"慢性萎缩性胃炎和失眠共同作用机制[J]. 辽宁中医药大学学报, 2021, 23(9): 118-124. https://www.cnki.com.cn/Article/CJFDTOTAL-LZXB202109025.htm
[24] 谢红丹, 张清, 麦联任. 乌梅丸加减联合三联疗法治疗老年HP阳性慢性萎缩性胃炎对患者胃动力及白介素族的影响[J]. 四川中医, 2022, 40(1): 103-106. https://www.cnki.com.cn/Article/CJFDTOTAL-SCZY202201030.htm
[25] 姜莉云, 吴文笛, 蔡悦青, 等. 基于"升举三阴法"论治慢性萎缩性胃炎探赜[J]. 中华中医药杂志, 2022, 37(2): 847-850. https://www.cnki.com.cn/Article/CJFDTOTAL-BXYY202202063.htm
-
下载:
图(1)
计量
- 文章访问数: 1317
- PDF下载数: 1854
- 施引文献: 0