[1]孔维枝,相宏杰,张海东,等.名中医曹志群基于“虚、瘀、毒”理论防治慢性萎缩性胃炎“炎、癌”转化经验[J].陕西中医,2023,(10):1443-1447.[doi:DOI:10.3969/j.issn.1000-7369.2023.10.025]
　KONG Weizhi,XIANG Hongjie,ZHANG Haidong,et al.Professor Cao Zhiqun's experience of preventing and treating “inflammation cancer transformation” of chronic atrophic gastritis from the aspects of deficiency,stasis and poison[J].,2023,(10):1443-1447.[doi:DOI:10.3969/j.issn.1000-7369.2023.10.025]
点击复制

名中医曹志群基于“虚、瘀、毒”理论防治慢性萎缩性胃炎“炎、癌”转化经验
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年10期
页码:
1443-1447
栏目:
名中医经验
出版日期:
2023-10-05

文章信息/Info

Title:
Professor Cao Zhiqun's experience of preventing and treating “inflammation cancer transformation” of chronic atrophic gastritis from the aspects of deficiency,stasis and poison
作者:
孔维枝1; 相宏杰2; 张海东1; 李晓彤1; 张 傲3; 曹志群1
(1.山东中医药大学第一临床医学院,山东 济南 250355; 2.山东省千佛山医院中医科,山东 济南 250355; 3.辽宁中医药大学中医学院,辽宁 沈阳 118047)
Author(s):
KONG Weizhi; XIANG Hongjie; ZHANG Haidong; LI Xiaotong; ZHANG Ao; CAO Zhiqun
(Shandong University of Traditional Chinese Medicine,Jinan 250355,China)
关键词:
慢性萎缩性胃炎;  胃癌前病变;  胃癌;  扶正化瘀解毒法;  炎癌转化;  芪莲舒痞方
Keywords:
Chronic atrophic gastritis;  Precancerous lesions of gastric cancer;  Gastric cancer;  Fuzheng Huayu Jiedu method;  Inflammation cancer transformation;  Qilian Shupi formula
分类号:
R 573.32
DOI:
DOI:10.3969/j.issn.1000-7369.2023.10.025
文献标志码:
A
摘要:
“炎、癌”转化是慢性萎缩性胃炎发生癌变的重要机制。曹志群教授扎根临床多年,对于防治慢性萎缩性胃炎“炎、癌”转化积累了丰富的临床经验,曹老师认为“虚、瘀、毒”为“炎、癌”转化的关键病机,其中正气亏虚是“炎、癌”转化的根本,瘀血、毒邪既是病机演变过程中的病理产物,也是致病因素,该转化总体上呈现出本虚标实、虚实夹杂之特性。曹老师将病因、病机和临床表现三者有机地进行结合,以及综合内镜、病理表现,提出以“扶正化瘀解毒”为基本治则,创立芪莲舒痞方以扶正补虚培中州、化瘀行滞通其络、解毒祛邪以防变,在改善临床症状,逆转萎缩、肠上皮化生、异型增生以及降低胃癌发生率方面,效果显著,体现了中医“治未病”之“既病防变”的原则,为中医防治慢性萎缩性胃炎“炎、癌”转化提供思路和方法。
Abstract:
The “inflammation cancer transformation” is an important mechanism for the carcinogenesis of chronic atrophic gastritis.Professor Cao Zhiqun has been rooted in clinical practice for many years and has accumulated rich clinical experience in preventing and treating the “inflammation cancer” transformation of chronic atrophic gastritis.Professor Cao Zhiqun believes that “deficiency,blood stasis,and toxin” are the key pathogenesis of the “inflammation cancer transformation”.Among them,deficiency of vital energy is the fundamental cause of the “inflammation cancer transformation”,and blood stasis and toxin are both pathological products and pathogenic factors in the process of disease pathogenesis evolution.Overall,this transformation presents the characteristics of the syndrome of deficiency and excess,with a mixture of deficiency and excess.Professor Cao organically combines the causes,pathogenesis,and clinical manifestations,as well as comprehensive endoscopic and pathological manifestations,and proposes the basic treatment principle of “nourishing the body,resolving blood stasis,and detoxifying”.He established the Qilian Shupi formula to nourish the body,nourish the central region,eliminate blood stasis,promote stagnation,and unblock its meridians,detoxify and eliminate pathogenic factors to prevent transformation.It has a significant effect in improving clinical symptoms,reversing atrophy,intestinal epithelial metaplasia,atypical hyperplasia,and reducing the incidence of gastric cancer.This reflects the principle of “pre treatment and prevention of existing diseases” in traditional Chinese medicine,and to provide ideas and methods for the prevention and treatment of chronic atrophic gastritis's “inflammation cancer transformation” in traditional Chinese medicine.

参考文献/References:

[1] Yu D,Ou Z,Zhang W,et al.Global and national trends in years of life lost and years lived with disability caused by three common gastrointestinal cancers from 1990 to 2019[J].BMC Gastroenterol,2022,22(1):493.
[2] Xu Q,Wang Y,Li ZY,et al.Therapeutic mechanisms of integrated traditional Chinese and conventional medicine underlying its treatment of precancerous lesions of gastric cancer[J].J Tradit Chin Med,2022,42(6):1023-1028.
[3] 左婷婷,郑荣寿,曾红梅,等.中国胃癌流行病学现状[J].中国肿瘤临床,2017,44(1):52-58.
[4] Li QY,Yang PH,Huang X,et al.Gastric mucosa pathology in rats with precancerous lesions of gastric cancer with spleen deficiency and blood stasis[J].Evid Based Complement Alternat Med,2022,2022:1366597.
[5] Li Y,Li T,Chen J,et al.Manpixiao decoction halted the malignant transformation of precancerous lesions of gastric cancer:From network prediction to in-vivo verification[J].Front Pharmacol,2022,13:927731.
[6] 宋媛媛,杨 龙,刘越洋,等.萎平舒胶囊对慢性萎缩性胃炎模型大鼠胃黏膜细胞自噬水平的影响[J].陕西中医药大学学报,2020,43(6):53-58.
[7] 张轶斐,于 淼,杨乔瑞,等.从伏邪理论探讨幽门螺旋杆菌感染与慢性萎缩性胃炎的关系[J].中国中医基础医学杂志,2022,28(4):562-564,629.
[8] 曾洪灏,钟 毅.邱健行治疗幽门螺旋杆菌感染胃炎经验[J].陕西中医,2023,44(1):108-111.
[9] 刘 鹏,江晓涛,聂课朝,等.肿瘤免疫细胞因子与慢性萎缩性胃炎“炎-癌转化”研究进展[J].中华中医药杂志,2022,37(6):3346-3351.
[10] 饶显俊,谢晶日,孙志文,等.谢晶日以“补土消积”疗法治疗慢性萎缩性胃炎伴低级别上皮内瘤变经验[J].陕西中医,2023,44(2):233-236.
[11] 杨 丽,郭栴子,杨小蒨,等.从“痰瘀互结”理论谈“炎-癌转化”[J].河北中医,2020,42(12):1887-1889.
[12] 薛宇爽,王 伟,卢 贞,等.曹志群基于“脾主卫”思想运用黄芪建中汤论治消化性溃疡临床经验[J].西部中医药,2022,35(8):40-43.
[13] 卫静静,李京尧,赵蓓蓓,等.论肾对胃癌前病变截断扭转的重要性及治疗策略[J].中华中医药杂志,2020,35(10):5064-5067.
[14] 黄秋月,叶 晖,史宗明,等.基于湿热理论认识幽门螺杆菌黏附致炎过程[J].世界中西医结合杂志,2021,16(1):185-188.
[15] 徐 洁,沈 洪.从虚瘀毒论治慢性萎缩性胃炎癌前病变[J].四川中医,2016,34(10):23-25.
[16] 廖文豪,牟 钰,赵茂源,等.基于毒邪致病理论治疗肿瘤疾病的思考[J].中国中药杂志,2023,48(5):1413-1419.
[17] 王郅宜,赵鲁卿,李丹艳.张声生从毒瘀互结论治胃癌前病变[J].环球中医药,2022,15(4):622-625.
[18] 庞立伟,刘冬梅,曹志群,等.从“脾虚毒损胃络”探讨CAG癌前病变的防治[J].时珍国医国药,2018,29(2):401-403.
[19] 相宏杰,赵 红,曹志群.运脾益肾、化瘀解毒法逆转CAG癌前病变的临床研究[J].中国实验方剂学杂志,2011,17(8):238-240.
[20] 彭剑岚,朱永苹,林寿宁,等.黄芪及其活性成分治疗胃癌的作用机制研究进展[J].中华中医药学刊,2023,41(4):196-201.
[21] 刘美红,邹峥嵘.女贞子化学成分、药理作用及药动学研究进展[J].热带亚热带植物学报,2022,30(3):446-460.
[22] 杨 洋,瞿先侯,杨 敏,等.慢性萎缩性胃炎患者中医证候分型与癌变风险的相关性[J].中医杂志,2020,61(4):319-324.
[23] 殷 静,易晋宇,徐 波,等.血瘀理论与慢性萎缩性胃炎的诊治[J].中华中医药学刊,2019,37(3):624-627.
[24] 沈 欢,邓海滨.中医药调节肿瘤免疫研究进展[J].河北中医,2020,42(2):307-311.
[25] 朱倩倩,洪 靖,谭 辉.中医药治疗慢性萎缩性胃炎研究进展[J].陕西中医药大学学报,2020,43(5):88-93.
[26] 王永琦,何冬雷,梁月祥,等.miR-650靶向PRDX2调控幽门螺旋杆菌对胃癌细胞氧化应激的机制研究[J].中国普通外科杂志,2023,32(2):231-238.
[27] 高 芳,卫星如,马立聪,等.TLR5基因单核苷酸多态性与幽门螺杆菌感染、非贲门胃癌发病风险的关联[J].中国老年学杂志,2022,42(15):3706-3710.
[28] 宋贵发,王 震,王晓妍.曹志群治疗消化系统疾病经验[J].山东中医杂志,2015,34(2):138-140.
[29] 刘包欣子,金志超,邵 杰,等.王瑞平教授运用解毒散结对药治疗恶性肿瘤经验[J].陕西中医,2021,42(11):1601-1606,1634.
[30] 相宏杰,王惠娟,曹志群.芪莲舒痞方对CAG大鼠胃黏膜血流量及病理形态影响的实验研究[J].世界中西医结合杂志,2013,8(2):181-183.
[31] 相宏杰,孙善美,宋鲁成,等.芪莲舒痞方影响CAG癌前病变大鼠突变型p53、Syk、Survivin表达的实验研究[J].时珍国医国药,2017,28(9):2068-2071.
[32] 吕林懋,曹志群,王淑敏,等.芪莲舒痞汤治疗慢性萎缩性胃炎癌前病变的临床研究[J].中国中西医结合消化杂志,2011,19(1):7-9.

相似文献/References:

[1]孙明明,李 聪,史 林.王庆国教授对慢性萎缩性胃炎的治疗经验探析[J].陕西中医,2019,(2):260.
　SUN Mingming,LI Cong,SHI Lin..Analysis on the treatment experience of chronic atrophic gastritis by professor WANG Qingguo[J].,2019,(10):260.
[2]钱元霞,汤玲珺,钱 祯,等.四逆散对慢性萎缩性胃炎癌前病变大鼠的作用及机制研究*[J].陕西中医,2019,(8):990.
　QIAN Yuanxia,TANG Lingjun,QIAN Zhen,et al.The effect of Sinisan on the rats of precancerous lesion of chronic atrophic gastritis and its mechanism[J].,2019,(10):990.
[3]闫 强,杨国强 △.健脾清胃汤治疗脾胃虚弱型慢性萎缩性胃炎疗效及对患者免疫功能的影响[J].陕西中医,2019,(8):1014.
　YAN Qiang,YANG Guoqiang..Effect of Jianpi Qingwei decoction on chronic atrophic gastritis of spleen and stomach deficiency and its influence on patients' immune function[J].,2019,(10):1014.
[4]杨宏升.安胃活血汤联合序贯法治疗慢性萎缩性胃炎胃癌前病变疗效研究[J].陕西中医,2019,(9):1195.
　YANG Hongsheng..Effect of Anwei Huoxue decoction combined with sequential therapy on gastric precancerous lesions of chronic atrophic gastritis[J].,2019,(10):1195.
[5]马佳乐 ,李慧臻.中医治疗慢性萎缩性胃炎研究进展*[J].陕西中医,2019,(11):1646.
　MA Jiale,LI Huizhen..Traditional Chinese medicine in the treatment of chronic atrophic gastritis[J].,2019,(10):1646.
[6]曾微微,麦联任,张 玲,等.健胃益脾汤治疗慢性萎缩性胃炎疗效及对患者胃蛋白酶原的影响*[J].陕西中医,2020,(11):1548.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.008]
　ZENG Weiwei,MAI Lianren,ZHANG Ling,et al.Effect of Jianwei Yipi decoction on treating chronic atrophic gastritis and its influence on pepsinogen[J].,2020,(10):1548.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.008]
[7]王 阳.基于络病理论探析慢性萎缩性胃炎“气络失和,毒损血络”病机*[J].陕西中医,2020,(11):1632.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.030]
　WANG Yang..Analysis of pathogenesis of chronic atrophic gastritis based on collateral disease theory[J].,2020,(10):1632.[doi:DOI:10.3969/j.issn.1000-7369.2020.11.030]
[8]张紫涵,陈 俊,徐 丹.苦参碱联合胃复春片治疗慢性萎缩性胃炎疗效及对患者血清胃蛋白酶原亚群的影响[J].陕西中医,2021,(3):323.[doi:DOI:10.3969/j.issn.1000-7369.2020.03.013]
　ZHANG Zihan,CHEN Jun,XU Dan.Effect of matrine combined with Weifuchun tablet on efficacy and serum pepsinogen subgroup in patients with chronic atrophic gastritis[J].,2021,(10):323.[doi:DOI:10.3969/j.issn.1000-7369.2020.03.013]
[9]寇 媛,闻新丽,薛 峰.养胃清热化瘀汤治疗慢性萎缩性胃炎及癌前病变临床研究[J].陕西中医,2021,(9):1233.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.021]
　KOU Yuan,WEN Xinli,XUE Feng.Clinical study on Yangwei Qingre Huayu decoction in treatment of chronic atrophic gastritis and precancerous lesions[J].,2021,(10):1233.[doi:DOI:10.3969/j.issn.1000-7369.2020.09.021]
[10]张 鹏,于 勇,万 强,等.补虚养胃汤加减治疗慢性萎缩性胃炎疗效及对患者胃肠功能的影响[J].陕西中医,2022,(1):66.[doi:DOI:10.3969/j.issn.1000-7369.2022.01.016]
[11]何金品,石 拓,陈星星.益气活血消痞法对慢性萎缩性胃炎胃癌前病变的影响研究[J].陕西中医,2022,(8):1032.[doi:DOI:10.3969/j.issn.1000-7369.2022.08.010]
　HE Jinpin,SHI Tuo,CHEN Xingxing.Clinical study on the treatment of chronic atrophic gastritis with precancerous lesions by Yiqi Huoxue Xiaopi method[J].,2022,(10):1032.[doi:DOI:10.3969/j.issn.1000-7369.2022.08.010]

备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助项目(82104723); 山东省自然科学基金资助项目(ZR2021LZY019,ZR2014HQ056,ZR2020MH355); 山东省中医药科技发展重点项目(2020Z14)
更新日期/Last Update: 2023-10-09