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提出“胃络伏风”是幽门螺杆菌相关性胃炎“炎-癌”转化的核心病机。胃络伏风融汇了胃风理论、伏邪学说与络病理论，指风邪深伏于胃络，兼具内外风邪及伏邪隐匿、待机而发的致病特点。据此将Correa级联反应重新划分为前驱期、进展期、转折期与癌变期四个阶段。前驱期以风毒外侵、络虚风动为发病之本；进展期风兼气郁、火邪、燥邪，呈现风邪挟郁、风火相煽、风燥相抟之象；转折期风酿痰涎、胃络瘀阻，为病情逆转的关键时间窗；癌变期风气亢变、络损成癥，驱动肿瘤进展与转移。治疗上提出全程祛风、分期论治原则，即针对络虚→络滞→络积的病机演变，前驱期治以疏风解毒、健脾荣络，进展期及转折期治以祛风兼邪、涤痰逐瘀，癌变期治以搜风剔络、散结消癥。
Abstract：It is considered that "latent wind in stomach collaterals" is the core pathogenesis underlying the inflammation-caner transformation of helicobacter pylori-associated gastritis(HpAG). The concept of "latent wind in stomach collaterals" integrates stomach wind theory, latent pathogen theory, and collateral disease theory, referring to wind pathogen deeply hidden in the stomach collaterals, characterized by both external and internal wind pathogen as well as latent pathogen that remain concealed and may be triggered under certain conditions. Accordingly, the Correa cascade is reclassified into four stages including the prodromal stage, progressive stage, transitional stage and carcinogenic stage. In the prodromal stage, the fundamental pathogenesis is described as "wind toxin invading externally with collateral deficiency and stirring of wind". In the progressive stage, wind is accompanied by qi constraint, fire pathogen, and dryness pathogen, manifesting as "wind pathogen complicated by constraint" "wind-fire agitation" and "wind-dryness interaction". In the transitional stage, "wind transforming into phlegm-drool and stomach collaterals being obstructed by stasis" is identified as a critical window for disease reversal. In the carcinogenesis stage, "wind-qi hyperactivity leading to pathological transformation, and collateral damage resulting in abdominal masses" drives tumor progression and metastasis. This paper proposes the treatment principle of "wind-dispelling throughout the entire process and stage-based treatment", according to the pathological evolution of "collateral deficiency-collateral stagnation-collateral accumulation". In the prodromal stage, it is suggested to dispel wind and resolve toxin, fortify spleen and tonify collaterals; in the progressive and transitional stage, the method of dispelling wind pathogen, clearing phlegm and eliminating stasis should be used; in the carcinogenesis stage, it is suggested to expel wind and remove pathogens from collaterals, disperse concretions and eliminate tumors.
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基本信息:
DOI：10.13288/j.11-2166/r.2026.13.006
中图分类号:R259
引用信息:
[1]刘川杨,成琳,储心乔,等.从“胃络伏风”探讨幽门螺杆菌相关性胃炎“炎-癌”转化的病机演变规律及治疗策略[J].中医杂志,2026,67(13):1383-1389.DOI:10.13288/j.11-2166/r.2026.13.006.
基金信息:
国家重点研发计划“中医药现代化研究”重点专项（2025YFC3512800,2025YFC3512803）; 中央高水平中医医院临床科研业务费资助项目（HLCMHPP2023085）; 中国中医科学院科技创新工程项目（CI2023C015YL）
2026-07-02
2026-07-02