CAJ | 학술논문

胃癌在全球最常见恶性肿瘤中排名第四位，是恶性肿瘤的第二大死因；其发现多在晚期，已经失去了根治性手术机会。晚期胃癌治疗手段主要包括姑息性手术治疗、放疗、化疗、生物免疫治疗、中医药治疗。姑息性手术治疗主要用于减轻患者肿瘤负荷，或减少并发症的发生；放疗在局部晚期胃癌的治疗中具有一定的效用。化疗在晚期胃癌治疗中可发挥主导作用，对有症状的患者有姑息性治疗效果，但目前尚未得到优势明显的标准治疗方案。胃癌的生物免疫治疗也逐渐成为研究热点，它是对手术和化、放疗的有益补充，但还不能作为主干性疗法。无论手术、放疗，或是化疗、生物免疫治疗，其在发挥疗效的同时，均具有明显的副作用。因此，采用中药内服外用、针灸推拿、心理干预等多种综合治疗手段，在缓解临床症状、对化、放疗减毒与增效、提高患者生存质量、预防肿瘤复发与转移、逆转肿瘤细胞多药耐药、治疗癌性腹水及癌性疼痛等方面的特色与优势，同样具有重要临床价值。本文针对近五年中医诊治晚期胃癌的概况，从其病因病机、辨证论治分型、中药及中成药单独或配合西医治疗晚期胃癌的疗效评价等多方面进行了归纳及总结，重在体现中医在诊治晚期胃癌中的作用和价值，为临床中诊治晚期胃癌提供新的思路。
위암재전구최상견악성종류중배명제사위，시악성종류적제이대사인；기발현다재만기，이경실거료근치성수술궤회。만기위암치료수단주요포괄고식성수술치료、방료、화료、생물면역치료、중의약치료。고식성수술치료주요용우감경환자종류부하，혹감소병발증적발생；방료재국부만기위암적치료중구유일정적효용。화료재만기위암치료중가발휘주도작용，대유증상적환자유고식성치료효과，단목전상미득도우세명현적표준치료방안。위암적생물면역치료야축점성위연구열점，타시대수술화화、방료적유익보충，단환불능작위주간성요법。무론수술、방료，혹시화료、생물면역치료，기재발휘료효적동시，균구유명현적부작용。인차，채용중약내복외용、침구추나、심리간예등다충종합치료수단，재완해림상증상、대화、방료감독여증효、제고환자생존질량、예방종류복발여전이、역전종류세포다약내약、치료암성복수급암성동통등방면적특색여우세，동양구유중요림상개치。본문침대근오년중의진치만기위암적개황，종기병인병궤、변증론치분형、중약급중성약단독혹배합서의치료만기위암적료효평개등다방면진행료귀납급총결，중재체현중의재진치만기위암중적작용화개치，위림상중진치만기위암제공신적사로。
In the world's most common malignant tumor, the stomach cancer ranks forth and it is the second cause of death among the malignant tumor.Most of them were diagnosed at the late stage, which makes them lose the opportunity to have radical surgery. The treatment of advanced stomach cancer include palliative operation, radiation, chemotherapy, biological immunotherapy and TCM treatment. The palliative operation is mainly used to alleviate the tumor load of the patients and to reduce complications. The radiation has certain effect on treating locally advanced stomach cancer. The chemotherapy plays leading role in the treatment of advanced stomach cancer. It has palliative effect on patients with symptoms. But at present, there is no standard treatment program which has a significant advantage. The biological immunotherapy for stomach cancer has also become the study focus. It is a good supplement for operation, radiation and chemotherapy, but it has not become the primary treatment. All the methods of operation, radiation, chemotherapy and biological immunotherapy have side effect. By various comprehensive treatment methods, such as internally and externally taking Chinese Materia Medica, acupuncture and psychological intervention, TCM shows characteristics and advantages in many respects, for example, relieving the clinical symptoms, reducing toxins of radiation and chemotherapy and increasing their effect, improving the life quality of the patients, preventing the recurrence and metastasis of tumor, overcoming MDR, treating carcinomatous ascites and pain. So the TCM treatment also has clinical value. This paper made an analysis and summary of the resent five year’s TCM diagnosis and treatment of advanced stomach cancer from the following respects: the cause and pathogen, the treatment based on syndrome differentiation, the evaluation of curative effect of using Chinese Materia Medica alone and combined with western medicine to treat advanced stomach cancer. The paper is focused on showing the effect and value of TCM on diagnosing and treating advanced stomach cancer, so as to provide new ideas for the clinical diagnosis and treatment of advanced stomach cancer.