Discuss on the Pathogenesis of Colorectal Precancerous from the Perspective of Traditional Chinese Medicine
-
摘要: 在癌毒病机理论的指导下，提出结直肠癌前病变的共性病机为湿热毒蕴，脾气亏虚。湿、热之邪在脾虚的基础上产生并相互胶结于肠腑，日久内生癌毒。脾气亏虚是结直肠癌前病变发生的根本病机，湿热蕴结是其发展条件，癌毒内生是癌变的关键所在。结合内镜下病理分级，根据癌毒内生与否可将结直肠癌前病变的演变过程分为无癌毒期及癌毒期。癌毒致病的过程即结直肠癌前病变发展成为结直肠癌的过程。因此，根据结直肠癌前病变处于无癌毒期或癌毒期的病机采取相应的治法，清除癌毒产生之源或已生之癌毒，可达到抑制其癌变，逆转癌瘤形成的目的。Abstract: Under the guidance of the theory of cancerous toxin pathogenesis, it is proposed that the common pathogenesis of colorectal precancerous lesion is damp-heat toxin accumulation and deficiency of spleen qi. Damp-heat toxin is induced by deficiency of spleen, retained in zang-fu organs and then transformed into cancerous toxin. Deficiency of spleen is the fundamental pathogenesis of colorectal pre-cancer lesion while damp-heat toxin accumulation is the development condition. The endogenous cancerous toxin is the key to cancerization. Combined with endoscopic pathological grading, the evolution of pre-colorectal lesion can be divided into cancerous toxin-free period and cancerous toxin period according to whether there is endogenous cancerous toxin or not. The process of disease onset induced by cancerous toxin is the process of colorectal precancerous lesion transforming into colorectal cancer. Therefore, according to the pathogenesis of colorectal precancerous lesion either in cancerous toxin-free period and cancerous toxin period, corresponding treatment methods should be applied to remove the source of cancerous toxin or endogenous cancerous toxin, which can achieve the purpose of inhibiting cancerization and reversing the formation of cancer.
-
Key words:
- colorectal cancer /
- pre-cancer lesion /
- cancerous toxin /
- pathogenesis /
- adenoma /
- inflammatory bowel disease
-
[1] ARNOLD M, SIERRA MS, LAVERSANNE M, et al. Global patterns and trends in colorectal cancer incidence and mortality[J]. Gut, 2016, 66(4): 683-691. [2] CHEN W, ZHENG R, BAADE PD, et al. Cancer statistics in China, 2015[J]. CA Cancer J Clin, 2016, 66(2) : 115-132. doi: 10.3322/caac.21338 [3] 吴东, 李景南, 钱家鸣. 炎症性肠病患者结直肠癌前病变的内镜诊治——美国炎症性肠病不典型增生监测与管理国际专家共识解读[J]. 中国实用内科杂志, 2016, 36(3): 195-198. https://www.cnki.com.cn/Article/CJFDTOTAL-SYNK201603008.htm [4] 王俊壹, 程海波. 基于"治未病"思想探讨癌毒病机理论在肿瘤防治中的应用[J]. 中医杂志, 2018, 59(12): 1014-1016. https://www.cnki.com.cn/Article/CJFDTOTAL-ZZYZ201812006.htm [5] NAGTEGAAL ID, ODZE RD, KLIMSTRA D, et al. The 2019 WHO classification of tumours of the digestive system[J]. Histopathology, 2020, 76(2): 182-188. doi: 10.1111/his.13975 [6] CANCER GENOME ATLAS N. Comprehensive molecular characterization of human colon and rectal cancer[J]. Nature, 2012, 487(7407): 330-337. doi: 10.1038/nature11252 [7] SEYEDIAN SS, NOKHOSTIN F, MALAMIR MD. A review of the diagnosis, prevention, and treatment methods of inflammatory bowel disease[J]. J Med Life, 2019, 12(2): 113-122. http://www.ncbi.nlm.nih.gov/pubmed/31406511 [8] 朱芸, 周晓军. 炎症性肠病的临床病理诊断[J]. 诊断病理学志, 2010, 17(6): 465-467. https://www.cnki.com.cn/Article/CJFDTOTAL-ZDBL201006026.htm [9] BALKWILL F, MANTOVANI A. Inflammation and cancer: Back to Virchow?[J]. Lancet, 2001, 357(9255): 539-545. doi: 10.1016/S0140-6736(00)04046-0 [10] 灵枢经[M]. 北京: 人民卫生出版社, 2005: 114. [11] 方美花, 仝欣, 陶智会, 等. 结直肠腺瘤息肉的中西医结合研究概况[J]. 湖南中医杂志, 2018, 34(7): 214-215. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZO201807098.htm [12] 缪春润, 沈洪. 沈洪教授治疗溃疡性结肠炎的经验[J]. 吉林中医药, 2008, 28(10): 709-710. doi: 10.3969/j.issn.1003-5699.2008.10.005 [13] 朱光建. 中医药治疗克罗恩病研究新况[J]. 世界最新医学信息文摘, 2019, 19(46): 112-113. https://www.cnki.com.cn/Article/CJFDTOTAL-WMIA201946050.htm [14] 王园园, 张驰, 刘红华, 等. 中医药治疗克罗恩病的研究进展[J]. 湖南中医杂志, 2018, 34(11): 168-170. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZO201811084.htm -
点击查看大图
计量
- 文章访问数: 282
- HTML全文浏览量: 103
- PDF下载量: 171
- 被引次数: 0
下载:
