浅谈食管胃结合部腺癌的中医病机特点及治疗

介绍笔者对食管胃结合部腺癌(Adenocarcinomas of the Esophagogastric Junction,AEG)即近端胃癌的中医病机特点的认识,认为食管胃结合部结构与功能不同于胃体及幽门,食管胃结合部主司贲门的契合开闭与食物的传输,是食物、药物进入胃内的狭窄通道,同时也是预防胃内容物返流进入食道的重要防线。其法天而用阳,主受纳通降,易耗气伤阴,受损胃络,表现为气滞、气逆、气虚等气机失调及由此而来痰、热、瘀、毒积聚,最终导致贲门枢机不利,进食不畅、哽噎、呕吐白色痰涎,甚至不能进食等症状。其病机特点是气机失调、痰毒郁结。治疗的关键是调理气机,驱邪扶正,把握贲门开合和降的生理,当补则补,当降则降。

Discussion on the pathogenesis and treatment of adenocarcinomas of the esophagogastric junction

The author’s understanding of the pathogenesis of AEG(Proximal gastric cancer)was introduced.He believed that the structure and function of AEG is different from the gastric body and pylorus.The main function of AEG is to open and close the cardia and transport the food,which is a narrow channel for entering the stomach of the food and drug.It is an important defense line to prevent the reflux of gastric contents into esophagus.It is easy to Haoqi Shangyin(耗气伤阴).It is characterized by Qizhi(气滞),Qini(气逆),Qixu(气虚),resulting in the accumulation of Tan(痰),Re(热),Yu(瘀)and Du(毒).Finally,it leads to Shuji Buli(枢机不利)of cardia,poor feeding,vomiting and white sputum of salivary gland,even unable to eat.Its pathogenesis is characterized by Qiji Shitiao(气机失调)and Tandu Yujie(痰毒郁结).The key of treatment is to regulate Qiis,Quxie Fuzheng(驱邪扶正),Dangbuzebu(当补则补),Dangjiangzejiang(当降则降).