摘要
食管癌是一种高发病率和死亡率的消化道恶性肿瘤,以男性患者居多,5年生存率低于20%。在我国,食管癌发病率和死亡率均位居世界之首,严重威胁国民健康。食管癌发病机制多样,基本认为是环境-遗传-基因互作的结果,除外遗传因素和地域性特征,基因突变、RNA干扰、DNA损伤修复、肿瘤微环境、饮食习惯、慢性不良刺激、炎症反应等均参与食管癌的发生与发展。但目前尚无统一、确切的定论,明确食管癌确切的发病机制对于其早期筛查、诊断、防治和预后等具有重要意义。手术、放疗、化疗是治疗食管癌的三大有效手段,但由于早期症状不典型,多数患者确诊时已错过最佳手术期而导致临床预后差,且放化疗会引起食欲不振、免疫功能低下、食管炎、肺炎和营养不良等,不利于患者预后和维持治疗。中医药治疗食管癌具有疗效确切、灵活多样等优势,即可作为主体又可作为辅助参与食管癌的治疗,且针对术后并发症、术后感染,放化疗所致消化道不良反应、免疫功能低下和脏器损伤等方面具有独特疗效,可增强临床疗效,提高患者生活质量。因此,有必要对目前研究相对明确的食管癌发病机制或危险因素进行系统总结,并针对中医药防治食管癌的临床特点进行综述,以利于食管癌的早期筛查、诊断和治疗,并促进中医药在食管癌防治和相关不良反应中的应用。
Esophageal cancer is a digestive tract malignancy with high morbidity and mortality and mainly occurs in males.The 5-year survival rate is lower than 20%.In China,the morbidity and mortality of esophageal cancer rank the first in the world,seriously threatening national health.The pathogenesis of esophageal cancer is diverse,which is generally considered as the consequence of environmental-genetic-gene interaction.In addition to genetic factors and regional characteristics,gene mutation,RNA interference,DNA damage repair,tumor microenvironment,dietary habit,chronic adverse stimulation,and inflammatory reaction are all involved in the occurrence and development of esophageal cancer.However,there is no unified and accurate conclusion.Clarifying the exact pathogenesis of esophageal cancer is of great significance for its early screening,diagnosis,prevention,treatment,and prognosis.Surgery,radiotherapy,and chemotherapy are the three effective methods for the treatment of esophageal cancer.However,due to the atypical early symptoms,most patients have missed the best operation period when diagnosed,resulting in poor clinical prognosis.Moreover,radiotherapy and chemotherapy will cause side effects such as loss of appetite,low immune function,esophagitis,pneumonia,and malnutrition,which is not conducive to the prognosis and treatment maintenance of patients.With definite efficacies on esophageal cancer,traditional Chinese medicine(TCM),which is flexible and diverse in the treatment,can primarily or alternatively be involved in the treatment of esophageal cancer.TCM can eliminate postoperative complications and postoperative infections and relieve adverse gastrointestinal reactions,weakened immune function,and organ damage caused by radiotherapy and chemotherapy.It can enhance clinical efficacy and improve the quality of life of patients.Therefore,it is necessary to systematically summarize the clear pathogenesis or risk factors of esophageal cancer and review the clinical characteristics of TCM in the prevention and treatment of esophageal cancer to facilitate the early screening,diagnosis,and treatment of esophageal cancer and promote the application of TCM in the prevention and treatment of esophageal cancer and related adverse reactions.
作者
彭孟凡
田硕
李晨辉
张媛鑫
苗晋鑫
苗明三
PENG Meng-fan;TIAN Shuo;LI Chen-hui;ZHANG Yuan-xin;MIAO Jin-xin;MIAO Ming-san(Henan University of Chinese Medicine,Zhengzhou 450046,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2022年第12期267-274,共8页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家中医药管理局标准化项目(GZY-FJS-2020-219)
河南省重大公益专项(201300310100)
河南省中医药科学研究专项(20-21ZYZD02)
河南省自然科学青年科学基金项目(202300410259)
中国博士后科学基金项目(2021T140184)
河南省博士后科研启动项目(202001043)。
关键词
食管癌
发病机制
中医药
作用特点
esophageal cancer
pathogenesis
traditional Chinese medicine
action characteristics
