摘要
中医学从时空的衡动与异动认识健康与疾病的关系,生理状态下气血津液代谢变化及病理过程中郁、痰、瘀的病理交叠无不与时空发展有关。肺结节“结癌转化”是交织耦合了时间累积效应、空间紊乱现象的复杂事件,时间上呈现由气化失常到形质病变的渐进趋势,空间上呈现从生理稳态破坏到病理产物形成的结构异化过程。文章在厘清肺结节“结癌转化”的时空本质与内在逻辑的基础上,提出“郁→痰→瘀→结”时空核心病机,气机郁闭为肺结节“结癌转化”之始,痰气胶着为肺结节“结癌转化”之基,痰阻瘀滞为肺结节“结癌转化”之进,瘀踞毒结为肺结节“结癌转化”之成。根据时间郁痰瘀结的病机演化趋势,透达气机以消生长之源,剔痰逐瘀以祛异常之形,解毒拔结以截恶化之势;根据空间气机郁闭、痰瘀阻络的病理状态,善用风药开玄,妙用温药化气,专用虫药通络,进而构建肺结节“结癌转化”时空辨治体系。
Chinese medicine recognizes the relationship between health and disease from the equilibrium and dissimilarity of time and space,and the metabolic changes of qi,blood and fluid in physiological state and the pathological overlapping of depression,phlegm and stasis in pathological process are all related to the development of time and space.Pulmonary nodules“nodule-cancer transformation”is a complex event coupled with the cumulative effect of time and the phenomenon of space disorder,which presents the progressive trend from qi malfunction to morphological and qualitative changes in time,and the process of structural heterogeneity from the destruction of physiological homeostasis to the formation of pathological products in space.On the basis of clarifying the essence and internal logic of pulmonary nodules“nodule-cancer transformation”,this paper puts forward the core mechanism of“depression→phlegm→stasis→junction”in time and space,in which depression and closure of qi is the beginning of pulmonary nodules“nodule-cancer transformation”,phlegm and qi sticking together is the foundation of pulmonary nodules“nodule-cancer transformation”,phlegm obstruction and stagnation is the advancement of pulmonary nodules“nodule-cancer transformation”,and stasis is pulmonary nodules“nodule-cancer transformation”into a poisonous junction.According to the evolution trend of the disease mechanism of time depression,phlegm and stasis,we should penetrate the qi to eliminate the source of growth,eliminate phlegm and stasis to get rid of the abnormal shape,and detoxify and pull out the knot to cut off the worsening trend;according to the pathological state of space depression of qi and phlegm and stasis obstruction of collaterals,we should make good use of the wind medicine to open up the mystery,make good use of the warm medicine to transform qi,and use the special medicine for the insect to open up the collaterals,and then we should build up time-space differentiation and treatment system for pulmonary nodules“nodule-cancer transformation”.
作者
雷茂
何佳玮
马琼
郑如意
向红霞
林冰
付西
郑川
由凤鸣
LEI Mao;HE Jiawei;MA Qiong;ZHENG Ruyi;XIANG Hongxia;LIN Bing;FU Xi;ZHENG Chuan;YOU Fengming(Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China;TCM Regulating Metabolic Diseases Key Laboratory of Sichuan Province,Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China;Cancer Research Institute,Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China)
出处
《时珍国医国药》
北大核心
2025年第15期2916-2921,共6页
JOURNAL OF LI-SHIZHEN TRADITIONAL CHINESE MEDICINE
基金
国家自然科学基金(82405359)
四川省自然科学基金(2024NSFSC1868)
四川省中医药管理局科学技术研究专项课题(2023MS512)。
关键词
肺结节
结癌转化
时间
空间
辨治体系
Pulmonary nodules
Nodule-cancer transformation
Time
Space
Differentiation and treatment system
