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从"主客浑受"辨治慢性胃炎"炎癌转化"OA

Differentiation and Treatment of Chronic Gastritis"Inflammation-Cancer Transformation"Based on the Theory of"Muddy Between Host and Guest"

中文摘要英文摘要

"主客浑受"系薛生白针对湿热病邪深入营血、胶结血脉之证提出的病机概括.慢性胃炎"炎癌转化"是由非可控性炎症向胃癌演变的复杂过程,其病机演变与"主客浑受"之正虚邪客、胶结难解的特点相契合.脾胃虚损为本,湿热内蕴,湿阻热灼成瘀,三者胶结不解,蕴积化变,终成"主客浑受"之态.病邪久羁,暗耗正气,胃黏膜反复损伤与异常修复,渐致萎缩、肠化、异型增生乃至癌变.治疗以分离主客为总则,动态把握病机演变,灵活运用扶正逐邪法,通过健脾固本、清热化湿、化瘀通络等法,分解湿、热、瘀胶结之态,旨在截断病势、逆转癌前病变,为中医药防治本病提供理论依据与临床思路.

The theory of"muddy between host and guest"was proposed by Xue Shengbai to characterize the pathogenesis of dampness-heat pathogens penetrating the nutrient-blood phase and intermingling with blood vessels.The"inflammation-cancer trans-formation"of chronic gastritis is a complex process evolving from non-resolving inflammation to gastric cancer,and its pathogenetic evolution aligns with the features of"muddy between host and guest",that is,deficient healthy qi with stubborn entrenchment of patho-genic factors.Spleen-stomach deficiency constitutes the root cause,with internal retention of dampness-heat.Dampness obstructs qi movement and heat scorches to generate stasis;these three factors intermingle inseparably,accumulate and transform,ultimately form-ing the state of"muddy between host and guest".Prolonged retention of pathogenic factors covertly consumes healthy qi,leading to re-peated gastric mucosal injury and aberrant repair,which gradually progresses to atrophy,intestinal metaplasia,dysplasia,and even car-cinogenesis.Treatment adheres to the general principle of"separating host and guest",dynamically capturing the pathogenetic evolu-tion,and flexibly applying the method of supporting healthy qi and eliminating pathogens.Through measures such as strengthening the spleen and consolidating the root,clearing heat and resolving dampness,and resolving stasis and unblocking collaterals,the entangled state of dampness,heat,and stasis is resolved.The aim is to halt disease progression and reverse precancerous lesions,thereby provid-ing a theoretical basis and clinical rationale for the prevention and treatment of this disease with traditional Chinese medicine.

闫海琳;徐婧;张涵灵;吕文亮

湖北中医药大学中医学院,湖北 武汉 430061||湖北三峡职业技术学院医学院,湖北 宜昌 443000新疆医科大学中医学院,新疆 乌鲁木齐 830054湖北中医药大学中医学院,湖北 武汉 430061湖北中医药大学中医学院,湖北 武汉 430061

医药卫生

主客浑受慢性胃炎炎癌转化正虚邪客湿热瘀结

muddy between host and guestchronic gastritisinflammation-cancer transformationhealthy qi deficiency with patho-gen retentiondampness-heat with stasis accumulation

《南京中医药大学学报》 2026 (6)

799-806,8

湖北省自然科学基金-中医药创新发展联合资助项目(2024AFD321)国家中医药管理局第七批全国老中医药专家学术经验继承工作项目(国中医药人教函[2022]76号)

10.14148/j.issn.1672-0482.2026.0799

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