[Pathogenesis of "inflammation cancer transformation" in chronic atrophic gastritis and TCM entropy-reducing prevention and treatment strategies based on entropy disease theory].

Gastric cancer(GC) is the fifth most common malignancy worldwide and the third leading cause of cancer-related deaths. Chronic atrophic gastritis(CAG) is the most common precursor lesion of GC, and its "inflammation cancer transformation" is a multi-step, multifactorial process. Based on the second law of thermodynamics, the theory of entropy disease posits that the essence of disease is a state of order imbalance caused by increased entropy in the body, which aligns with the pathogenesis of CAG's inflammation cancer transformation. According to this theory, the essence of CAG inflammation cancer transformation is an entropy-increasing process evolving from a relatively ordered pathological state to a highly disordered cancerous state. In the initial stage, spleen-stomach deficiency and Qi stagnation with dampness obstruction disrupt energy metabolism, leading to elevated entropy. In the critical stage, accumulation and congealing of toxins and stasis, combined with deficiency of both Qi and Yin, destabilize gastric microenvironment homeostasis and accelerate entropy increase. In the qualitative transformation stage, deficiency of both Yin and Yang and exuberant cancer toxins cause collapse of the body's regulatory mechanisms; when the entropy increase exceeds a threshold, cancerogenesis occurs. For treatment, a three-stage prevention and intervention strategy of "reducing entropy-inhibiting entropy-reversing entropy" is proposed. In the early stage, fortifying the spleen, replenishing Qi, regulating Qi, and resolving dampness aim to correct energy metabolism disorders. In the middle stage, replenishing Qi and nourishing Yin, clearing heat and removing toxins, and activating blood circulation to resolve stasis aim to restore homeostasis in the gastric microenvironment. In the late stage, nourishing Yin and warming Yang, reinforcing healthy Qi, consolidating constitution, and removing toxins to combat cancer aim to rebuild a low-entropy, ordered state. By integrating the entropy disease theory with both TCM and western medical understanding, this paper establishes an interdisciplinary theoretical framework for early intervention in CAG's inflammation cancer transformation, providing a novel theoretical perspective and diagnostic approach for early prevention and intervention, with important clinical and research significance.