School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.
Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
J Altern Complement Med. 2019 Nov;25(11):1130-1139. doi: 10.1089/acm.2017.0386. Epub 2018 Mar 22.
Chronic atrophic gastritis (CAG) is the precancerous stage of gastric carcinoma. Traditional Chinese Medicine (TCM) has been widely used in treating CAG. This study aimed to reveal core pathogenesis of CAG by validating the TCM syndrome patterns and provide evidence for optimization of treatment strategies. This is a cross-sectional study conducted in 4 hospitals in China. Hierarchical clustering analysis (HCA) and complex system entropy clustering analysis (CSECA) were performed, respectively, to achieve syndrome pattern validation. Based on HCA, 15 common factors were assigned to 6 syndrome patterns: liver depression and spleen deficiency and blood stasis in the stomach collateral, internal harassment of phlegm-heat and blood stasis in the stomach collateral, phlegm-turbidity internal obstruction, spleen deficiency, internal harassment of phlegm-heat and spleen deficiency, and spleen deficiency. By CSECA, 22 common factors were assigned to 7 syndrome patterns: deficiency, stagnation, blood stasis, phlegm turbidity, heat, deficiency, and deficiency. Combination of deficiency, stagnation, blood stasis, phlegm turbidity, heat, deficiency, and deficiency play a crucial role in CAG pathogenesis. In accord with this, treatment strategies by TCM herbal prescriptions should be targeted to regulating , activating blood, resolving turbidity, clearing heat, removing toxin, nourishing , and warming . Further explorations are needed to verify and expand the current conclusions.
慢性萎缩性胃炎(CAG)是胃癌的癌前阶段。中医药在治疗 CAG 方面得到了广泛应用。本研究旨在通过验证中医证候模式,揭示 CAG 的核心发病机制,并为优化治疗策略提供证据。本研究为在中国的 4 家医院进行的横断面研究。分别进行层次聚类分析(HCA)和复杂系统熵聚类分析(CSECA),以验证证候模式。基于 HCA,将 15 个共同因素分配到 6 个证候类型:肝郁脾虚血瘀胃络、胃络痰热血瘀内扰、痰浊内阻、脾虚、胃络痰热脾虚、脾虚。通过 CSECA,将 22 个共同因素分配到 7 个证候类型:脾虚、气滞、血瘀、痰浊、热盛、津亏、血虚。脾虚、气滞、血瘀、痰浊、热盛、津亏、血虚的组合在 CAG 发病机制中起着关键作用。与此相符,中医方剂的治疗策略应针对调节气、活血、化痰、清热、解毒、滋阴、温阳。需要进一步探索以验证和扩展当前的结论。