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基于风火相煽理论，结合现代医学对慢性萎缩性胃炎（CAG）炎-癌转化机制的认识，认为CAG持续存在的炎症反应可类比为“火”之偏亢，而疾病进展过程中上皮细胞结构与性质的动态改变则与“风”的善行数变特点相契合。炎症反复刺激可导致胃黏膜上皮细胞肠上皮化生、异型增生乃至癌变发生，而异常细胞又可进一步放大炎症反应，形成风火相互促进的恶性循环。基于此，治疗当以清遏偏盛之火邪、平息内动之风邪为基本原则，并结合病程演变进行分期辨治：初期以清解气分湿热为主，以断火炽风萌之根；中期重在凉血化瘀、调气解郁，以息血瘀风动之势；后期侧重搜风解毒、扶正固本，以防风毒互结之变。
Abstract：Based on the theory of "wind and fire aggravating each other" in traditional Chinese medicine(TCM), and combined with current understanding of the mechanisms underlying the inflammation-to-cancer transformation of chronic atrophic gastritis(CAG) in modern medicine, this paper proposes that the persistent inflammatory response in CAG is considered analogous to excessive "fire", while dynamic changes in epithelial cell structure and characteristics during disease progression correspond to the concept of "wind" in TCM, which is characterized by mobility and frequent changes. Recurrent inflammatory stimulation may promote intestinal metaplasia, dysplasia, and even malignant transformation of gastric epithelial cells, whereas abnormal cells can further amplify local inflammatory responses, forming a vicious cycle driven by the mutual aggravation of wind and fire. On this basis, treatment should focus on clearing excessive pathogenic fire and calming internal pathogenic wind, with therapeutic strategies adjusted according to disease progression. In the early stage, clearing damp-heat in the qi level is emphasized to block the escalation of fire and the generation of wind. In the middle stage, the method of cooling the blood and dissolving stasis, regulating qi and resolving constraint is applied to alleviate the progression of stasis and wind activation. In the advanced stage, the therapeutic focus shifts toward dispelling wind and resolving toxins, while strengthening the body's resistance and consolidating the foundation to prevent the transformation caused by wind-toxin accumulation.
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基本信息:
DOI：10.13288/j.11-2166/r.2026.15.005
中图分类号:R259
引用信息:
[1]龙俊余,吕文良.从风火相煽理论探讨慢性萎缩性胃炎炎-癌转化及治疗思路[J].中医杂志,2026,67(15):1608-1612+1622.DOI:10.13288/j.11-2166/r.2026.15.005.
基金信息:
中国中医科学院基本科研业务费新入职青年科研人员培养专项（ZZ18-XRZ-024）; 中央高水平中医医院临床研究和成果转化能力提升项目（HLCMHPP2023086）
2026-08-02
2026-08-02