胃“炎－癌转化”的中西医结合慢病管理与获益
Combining traditional Chinese and Western medicine for management and benefits of gastric inflammation-cancer transformation
- 现代中医临床 2023年30卷第4期 页码：69-74
- 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：
杨洋，女，博士，主治医师
# 魏玮，男，博士，主任医师，博士生导师，E-mail：sxxtyy@sina.com
- 基金信息：中国中医科学院科技创新工程项目(CI2021A01820);国家自然科学基金资助项目(82204865);中国中医科学院基本科研业务费优秀青年科技人才培养专项(ZZ16－YQ－024);中国中医科学院望京医院自主选题专项(WJYY－ZZXT－2022－04)
DOI：10.3969/j.issn.2095-6606.2023.04.015
中图分类号： R259纸质出版日期：2023-07-30，
收稿日期：2022-04-08，
- 稿件说明：
移动端阅览
杨洋, 张平, 魏玮. 胃“炎－癌转化”的中西医结合慢病管理与获益[J]. 现代中医临床, 2023,30(4):69-74.
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, 2023,30(4):69-74.
杨洋, 张平, 魏玮. 胃“炎－癌转化”的中西医结合慢病管理与获益[J]. 现代中医临床, 2023,30(4):69-74. DOI： 10.3969/j.issn.2095-6606.2023.04.015.
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, 2023,30(4):69-74. 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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