Gastric precancerous lesion (PLGC) is a pathological concept, including intestinal epithelial metaplasia (IM) and heterogeneous hyperplasia (Dys), which is an important stage in the process of transformation from normal gastric mucosa to gastric cancer. The study of gastric precancerous lesions becomes one of the important elements of secondary prevention of gastric cancer. Early identification and prevention of precancerous diseases and pre-cancerous lesions have become a more effective method to reduce the incidence and mortality of gastric cancer.
The therapeutic effect of TCM on CAG and PLGC is gaining more and more attention, so that it has become the focus of research on gastric cancer prevention and treatment, and related reports are increasing year by year. In summary, the combination of macroscopic and microscopic diagnosis is advocated, and the treatment is always based on strengthening the spleen, invigorating blood and regulating qi, detoxifying and anti-cancer.
Its research methods can be roughly divided into 4 types.
1.Treatment by differentiation and typing;
2.Treatment by adding and subtracting basic formulae;
3.Fixed formula treatment;
4. Combined treatment of Chinese and Western medicine.
For the principles of this disease, there are mainly the following views.
First, the treatment of this disease should follow the “Nei Jing”: “deficiency is tonic, the real is diarrhea”, as discussed in the “Miscellaneous Diseases Source and Flow Rhinocandle”: “deficiency is to tonic its qi, the real is to eliminate food, expel phlegm, dry dampness, clear heat, eliminate the guide, but not to be steep.”
Second, to support the righteousness and eliminate the evil, the principle of both the symptoms and the root cause.
1.Improve the immune function of the body and enhance the anti-cancer ability;
2.Improve and eliminate the carcinogenic gastric environment, such as reduction of gastric acid secretion, increase of cells in the stomach, weakening of gastric transportation, delayed emptying time, and disturbance of gastrointestinal hormone secretion, etc;
3.Reducing or eliminating the existing gastric mucosa intestinalization and heterogeneous hyperplasia, so that they do not develop into gastric cancer, inhibiting cell differentiation and proliferation, and preventing cell mutation;
4.Block and neutralize the residual carcinogenic substances (such as nitrosamines) and their synthesis process in the stomach.
Third, emphasize the “one down, two regulation, three combination”.
”A drop” is to lower the stomach and rebellion, through the lowering of the stomach. The “two adjustments” refers to the regulation of the spleen and stomach, and the liver and stomach; the second refers to the reconciliation of other organs and the physiological functions of the stomach, as well as the pathological changes of the Shengke multiplied by the insult. The “three combinations” refer to the combination of disease identification and evidence identification, the combination of basic treatment and stage treatment, and the combination of drug treatment and conditioning.
Drug treatment methods for this disease: 1.
1. Identification and typing treatment.
According to the “Trial Program of Diagnosis, Identification and Efficacy Standards of Chronic Gastritis in Chinese and Western Medicine” formulated by the Chinese Society of Integrative Medicine in 1989, chronic gastritis can be generally divided into five types of evidence, namely, weak spleen and stomach (including cold), spleen and stomach disharmony, stomach yin deficiency, spleen and stomach dampness and heat, and stomach complex blood stasis.
2. Basic formula plus or minus treatment.
By repairing and protecting the barrier structure and function of the stomach wall, it is an important role link of the spleen strengthening method to prevent and treat precancerous lesions of gastric cancer. The weakening of the barrier function of the stomach wall due to spleen deficiency is an important condition leading to the occurrence of gastric precancerous lesions, so its occurrence and progress can be prevented by protecting the stomach wall barrier. Clinical studies have shown that strengthening the spleen and replenishing Qi can effectively reverse mucosal atrophy, IM and Dys while improving gastric wall barrier defense function, and effectively prevent gastric precancerous lesions. Prof. Jingri Xie has been using XinGui granules as the main formula for the treatment of gastric precancerous lesions with remarkable efficacy.
3.Combination of Chinese and Western medicine treatment.
The main mode is to identify the evidence in Chinese medicine and the disease in Western medicine, mainly focusing on the identification of deficiency, stagnation, stasis and toxicity of deficiency and reality; the treatment methods are different with the identification of the basic formula plus or minus or fixed specific formula. Research on molecular biology of tumors has shown that drugs can achieve therapeutic purposes through specific modulation of gene expression in tumor cells. Although it is very unlikely that drugs can repair the mutated DNA of tumors, it is perfectly possible to interfere with and regulate the replication, transcription and translation of their related genes in order to improve the expression of oncogenes or their own cytokine genes, and the complexity of TCM components is an advantage over single-component drugs in regulating the expression of tumor-related genes that need to be regulated by multiple genes at the same time; This is in line with the focus of TCM treatment on overall regulation to achieve therapeutic goals.