摘要
原发性肝癌(primary hepatic carcinoma,PHC)是一种全球性的重大公共卫生问题,其发病率和死亡率居高不下,在中国乃至全球疾病负担尤为严重。PHC发病机制复杂,涉及黄曲霉素暴露、酒精中毒、病毒感染等多种病理因素。中医学将PHC归为“肝积”“积聚”等范畴,认为其病机与七情内伤、外感邪毒、饮食不节、虫毒痰瘀、正气亏虚等因素密切相关。本团队基于《黄帝内经》积证理论,结合络病学中“通络”之概念,提出“络息成积”为PHC之核心病机,表现为络气虚滞,正虚毒结;络气郁滞,气积成毒;络脉瘀阻,久积成毒;痰浊阻络,癌毒内聚等,治以益气通络、流气畅络、祛痰通络、化瘀通络为主,旨在通过扶正、化积、消癌、活血以解癌毒、破积瘀,达到邪去正安之效果,进一步深化积证理论在PHC及其他难治性疾病中的应用,以期为临床诊疗本病提供新视角与新思路。
Primary hepatic carcinoma(PHC)represents a significant global public health challenge,characterized by high morbidity and mortality rates.The disease burden is particularly pronounced in China and globally.The etiology of PHC is multifaceted,involving various pathogenic factors such as aflatoxin exposure,alcohol abuse,viral infections,and others.According to Traditional Chinese Medicine(TCM),PHC can be categorized under ganji(liver accumulation)and jju(accumulationgathering),with its pathogenesis closely linked to emotional damages,contraction of exogenous pathogenic toxins,improper diet,insect poisons,phlegm stasis,blood stasis,and deficiency of vital qi.Drawing on the accumulation syndrome theory from the Huangdi Neijing(Yellow Emperor's Inner Canon)and the concept of"dredging collaterals"from the study of collateral diseases,Professor Sun Zhiwei's team proposed that the core pathogenesis of PHC is"collateral-qi stagnation".This condition is marked by the stagnation of collateral-qi,leading to healthy qi deficiency and toxin aggregation.Specifically,qi stagnation transforms into toxin accumulation;collaterals become blocked,resulting in prolonged cancer toxin accumulation.Treatment primarily focuses on enhancing qi to unblock collaterals,promoting qi flow to clear collaterals,eliminating phlegm to unblock collaterals,and removing blood stasis to unblock collaterals.The ultimate goal is to reinforce healthy qi,dissolve accumulations,eliminate cancerous toxins,and promote blood circulation thereby achieving the goal of expelling pathogens to restore harmony.This approach seeks to deepen the application of accumulation pathology theory in PHC and other refractory diseases,offering novel perspectives and strategies for clinical application.
作者
董银星
宁博
郭曜宁
杨栎曼
陈业盛
费振浩
孙志为
DONG Yinxing;NING Bo;GUO Yaoning;YANG Liman;CHEN Yesheng;FEI Zhenhao;SUN Zhiwe(Yunnan University of Chinese Medicine,Kunming 650500;Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine;YunnanFirst Peoples Hospital)
出处
《现代中医临床》
2025年第4期43-48,共6页
Modern Chinese Clinical Medicine
基金
云南省医学领军人才基金项目(No.L2017-016)
科创医学发展基金会面上项目(No.KC2023-JX-0288-FQ19)
陕西省重点研发计划-重点产业创新链(群)项目(No.2024SF-ZDCYL-03-21)
云南省第一人民医院普通外科重点专科(肝胆胰外科)平台开放项目(No.2024GDKFKT-04)。
关键词
原发性肝癌
积证理论
通络法
中医辨治
理论探讨
primary liver cancer
accumulation syndrome theory
the method of dredging collaterals
TCM treatment
theoretical discussion
