慢性萎缩性胃炎中西医研究进展

Progress in Traditional Chinese and Western Medicine in Chronic Atrophic Gastritis

摘要: 慢性萎缩性胃炎(chronic atrophic gastritis, CAG)是慢性胃炎的一种类型，系指胃黏膜上皮遭受反复损害导致固有腺体的减少，伴或不伴肠腺化生和(或)假幽门腺化生的一种慢性胃部疾病。大多数该病患者无特异性临床表现，多因中上腹部不适、餐后饱胀、口苦、烧心、泛酸等症就诊，行胃镜、病理检查后方才确诊。世界卫生组织(WHO)早在多年前就指出了CAG属于胃癌的癌前状态，其中若是伴有肠化或不典型增生，癌变风险则会进一步增加。相关研究表明国外CAG的癌变率为8.6%~13.8%，而我国CAG的癌变率为1.2%~7.1%。不同地域饮食结构及生活习惯各有不同，饮食偏嗜、喜好烟酒浓茶、熬夜、各方面压力等均可导致胃肠疾病的发生发展，目前CAG的检出率也呈现逐渐上升趋势，而CAG作为胃癌的癌前状态，不得不引起我们的注意。CAG患者多为老年人，近50%胃黏膜存在萎缩改变的为50岁以上老年人，70%在40岁以上。国外研究发现，如南美、东亚、东欧等胃癌高发地，CAG的检出率也是居高不下的。荷兰通过10年对92,250例胃癌前病变患者进行随访发现肠化和萎缩性胃炎的胃癌发生率0.25/年和0.1%/年。国内研究调查发现，CAG患者主要集中于广西、福建、黑龙江等地，该病检出率约占胃镜检查的7.5%~13.8%。青海省人民医院消化内科通过研究本院187例胃镜检查报告显示：青海地区CAG发生率显著高于平原地区，胃镜室所检病种中CAG构成比高达72.47%，CAG发病率随年龄增长而增加。故探讨慢性萎缩性胃炎的研究进展至关重要，本文从中西医结合的角度论述慢性萎缩性胃炎的研究进展，为临床科研提供相应的帮助。

Abstract: Chronic atrophic gastritis (chronic atrophic gastritis, CAG) is a type of chronic gastritis, which refers to a chronic gastric disease leading to the reduction of native glands, with or without intestinal metaplasia and (or) pseudopyloric metaplasia. Most of the patients with this disease do not have specific clinical manifestations, and are usually due to middle and upper abdominal discomfort, postprandial fullness, bitter mouth, heartburn, pantothenic acid and other diseases, which are confirmed after gastroscopy and pathological examination. The World Health Organization (WHO) pointed out that CAG is a precancerous state of gastric cancer many years ago, where the risk of cancer is accompanied by enterization or atypical hyperplasia. Related studies show that the cancer rate of CAG abroad is 8.6%~13.8%, while the cancer rate of CAG in China is 1.2%~7.1%. Different regions have different dietary structure and living habits, including preference for eating, tobacco, alcohol and tea, staying up late, and all aspects of pressure can lead to the occurrence and development of gastrointestinal diseases. At present, the detection rate of CAG is also gradually rising trend, and CAG, as a precancerous state of gastric cancer, has to attract our attention. Most of the CAG patients are elderly, nearly 50% of the gastric mucosa is over 50 years old, and 70% are over 40 years old. Foreign studies have found that the detection rate of CAG in the high incidence of gastric cancer in South America, East Asia and Eastern Europe, is also high. In the Netherlands, 92,250 patients with precancerous gastric lesions for 10 years found enteric and atrophic gastric gastritis incidence 0.25/year and 0.1%/year. Domestic research found that CAG patients are mainly concentrated in Guangxi, Fujian, Heilongjiang and other places, and the detection rate of this disease accounts for about 7.5%~13.8% of gastroscopy. Through the study of the gastroscopy report of 187 cases, the incidence of CAG in Qinghai was significantly higher than that in the plain area, the composition ratio of CAG in the gastroscopy room was as high as 72.47%, and the incidence of CAG increased with the increase of age. Therefore, it is very important to discuss the research progress of chronic atrophic gastritis. This paper discusses the research progress of chronic atrophic gastritis from the perspective of combining traditional Chinese and western medicine, and provides corresponding help for clinical scientific research.