袁红霞治疗胃癌前病变经验
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摘要
袁红霞教授认为胃癌前病变以脾胃正气亏虚为本,瘀热毒邪留滞为标,病机发展是由轻到重、因实致虚的渐变过程。根据虚瘀的病机演变,袁教授将胃癌前病变分为血瘀热毒、阴虚有热和气阴两虚夹瘀三种证型,并提出在疾病不同阶段,应按照虚瘀特点,参考内镜及病理检查,采取不同治法:早期肠化/异型增生程度较轻时着力祛邪,中期轻中度肠化/异型增生时扶正与祛邪并举,后期病情进展,肠化/异型增生程度较重,以益气扶正为主。列举验案1则以说明疗效。
Professor YUAN Hongxia thinks that the fundamental pathogenesis of precancerous lesions of gastric cancer(PLGC) is the deficiency of spleen and stomach,besides,the toxin caused by the accumulation of blood stasis and heat is also an important part of the pathogenesis. The development of the pathogenesis is a gradual process from light to heavy,excess to deficiency. According to the development of the pathogenesis,including deficiency and blood stasis,Professor YUAN divides PLGC into blood stasis and heat toxic syndrome,yin deficiency and heat syndrome and qi and yin deficiency accompanied by blood stasis syndrome. She puts forward the idea that at different stage of the disease,according to the characteristics of blood stasis and deficiency and with reference to endoscopy and pathological examination,different methods should be adopted. In the early stage when the intestinal metaplasia/dysplasia is mild,the treatments should focus on eliminating pathogenic factors. In the middle stage when the intestinal metastasis/dysplasia is developing from mild to moderate,strengthening body resistance and eliminating pathogenic factors are combined.In the later stage when the disease advances and the intestinal metastasis/dysplasia is severe,supplying qi to strengthening body resistance is the main method. A case is listed to illustrate the efficacy.
Professor YUAN Hongxia thinks that the fundamental pathogenesis of precancerous lesions of gastric cancer(PLGC) is the deficiency of spleen and stomach,besides,the toxin caused by the accumulation of blood stasis and heat is also an important part of the pathogenesis. The development of the pathogenesis is a gradual process from light to heavy,excess to deficiency. According to the development of the pathogenesis,including deficiency and blood stasis,Professor YUAN divides PLGC into blood stasis and heat toxic syndrome,yin deficiency and heat syndrome and qi and yin deficiency accompanied by blood stasis syndrome. She puts forward the idea that at different stage of the disease,according to the characteristics of blood stasis and deficiency and with reference to endoscopy and pathological examination,different methods should be adopted. In the early stage when the intestinal metaplasia/dysplasia is mild,the treatments should focus on eliminating pathogenic factors. In the middle stage when the intestinal metastasis/dysplasia is developing from mild to moderate,strengthening body resistance and eliminating pathogenic factors are combined.In the later stage when the disease advances and the intestinal metastasis/dysplasia is severe,supplying qi to strengthening body resistance is the main method. A case is listed to illustrate the efficacy.
引文
[1] CHEN W,ZHENG R,BAADE P D,et al. Cancer statistics in China,2015[J]. Ca Cancer J Clin,2016,66(2):115-132.
[2] Correa P. Human Gastric Carcinogenesis:A Multistep and Multifactorial Process——First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention[J]. Cancer Research,1992,52(24):6735-6740
[3]杨晋翔,魏玥,彭继升,等.中医药治疗胃癌前病变临床述评[J].北京中医药大学学报(中医临床版),2013,20(1):7-11.
[4]朱步先,朱胜华,蒋熙,等.朱良春用药经验集[M].长沙:湖南科技出版社,2005:52-53.
[5]张锡纯.医学衷中参西录[M].太原:山西科技出版社,2011:168-169.庶虫
[2] Correa P. Human Gastric Carcinogenesis:A Multistep and Multifactorial Process——First American Cancer Society Award Lecture on Cancer Epidemiology and Prevention[J]. Cancer Research,1992,52(24):6735-6740
[3]杨晋翔,魏玥,彭继升,等.中医药治疗胃癌前病变临床述评[J].北京中医药大学学报(中医临床版),2013,20(1):7-11.
[4]朱步先,朱胜华,蒋熙,等.朱良春用药经验集[M].长沙:湖南科技出版社,2005:52-53.
[5]张锡纯.医学衷中参西录[M].太原:山西科技出版社,2011:168-169.庶虫