Combining traditional Chinese and Western medicine for management and benefits of gastric inflammation-cancer transformation

YANG Yang; ZHANG Ping; WEI Wei

doi:10.3969/j.issn.2095-6606.2023.04.015

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Combining traditional Chinese and Western medicine for management and benefits of gastric inflammation-cancer transformation

Ideas and Methodologies | 更新时间：2023-08-07

- Combining traditional Chinese and Western medicine for management and benefits of gastric inflammation-cancer transformation
- Modern Chinese Clinical Medicine Vol. 30, Issue 4, Pages: 69-74(2023)
- 作者机构：
  
  1.中国中医科学院望京医院　北京　100102
  2.功能性胃肠病北京市重点实验室〔BZ0374〕
- 作者简介：
- 基金信息：
- DOI：10.3969/j.issn.2095-6606.2023.04.015
  CLC： R259
- Published：30 July 2023，
  
  Received：08 April 2022，
- 稿件说明：
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YANG Yang, ZHANG Ping, WEI Wei. Combining traditional Chinese and Western medicine for management and benefits of gastric inflammation-cancer transformation. [J]. Modern Chinese Clinical Medicine 30(4):69-74(2023)
DOI：

YANG Yang, ZHANG Ping, WEI Wei. Combining traditional Chinese and Western medicine for management and benefits of gastric inflammation-cancer transformation. [J]. Modern Chinese Clinical Medicine 30(4):69-74(2023) DOI： 10.3969/j.issn.2095-6606.2023.04.015.

摘要

慢性萎缩性胃炎(CAG)是消化系统常见慢性疾病及癌前疾病，黏膜萎缩基础上伴发肠上皮化生及异型增生是胃癌前病变。肠型胃癌是有着明确演化阶段的“炎－癌转化”过程。胃“炎－癌转化”过程是一个缓慢的过程，呈现的动态、可逆的特点为抑制病情进展提供了特殊机会。胃癌前状态的主要干预手段包括根除幽门螺杆菌治疗及药物治疗。CAG的干预应是一个综合但又个性化的慢病管理过程。在规范的疾病管理中，每个环节均需体现中医特色，在“上工治未病”的思想指导下分层次管理。未病先防是疾病管理的第一层次，主要针对无症状人群或疾病缓解期症状消失的人群。既病防变是疾病管理的第二层次，也是关键层次，需严格控制胃癌高危因素和定期监测病情。最后为愈后防复。对于胃“炎－癌转化”慢病管理的获益评价要着眼于全程、着眼于远期、着眼于患者，全面阐释中西医结合的优势。

Abstract

Chronic atrophic gastritis (CAG) is a common chronic disease and precancerous disease of the digestive system. Gastric atrophy accompanied by intestinal metaplasia and dysplasia is a precancerous lesion of gastric cancer. Patients with intestinal-gastric cancer generally go through a process of "inflammation-carcinoma transformation" with clearly defined progressive stages. It is a slow process with dynamic and reversible characteristics

which provides a special window of opportunity to inhibit the progression of the disease. The main intervention means of pregastric cancer is Helicobacter pylori eradication

followed by drug therapy. The intervention of CAG should be a comprehensive but personalized process of chronic disease management. In the standardized disease management

traditional Chinese medicine (TCM) elements are contained in every step and staged management is needed under the guidance of the TCM ideal of "treating the disease before it arises" . Prevention is the first level of disease management

mainly aimed at asymptomatic patients or people with relieved symptoms. Controlling the development of existing disease is the second and key level of disease management

which requires strict control of risk factors for gastric cancer and regular monitoring of disease progression. Finally

recurrence must be avoided. The benefit evaluation of chronic disease management for "inflammation-carcinoma transformation" in stomach should be patient-oriented

focus on the whole course

long-term prospect and fully explain the advantages of integrated Chinese and Western medicine to the patient.

关键词

慢性萎缩性胃炎胃癌前病变病理组织学中医药干预慢性管理

Keywords

chronic atrophic gastritisprecancerous lesions of gastric cancerhistopathologyintervention of traditional Chinese medicinechronic disease management

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