胰腺癌中医证治理论体系的现代认识  

Modern Interpretation of the Theoretical System of Chinese Medicine Syndrome Treatment in Pancreatic Cancer

作　　者：花永强 刘鲁明[1,2] 陈震 孟志强[1,2] 陈颢 王鹏[1,2] HUA Yong-qiang;LIU Lu-ming;CHEN Zhen;MENG Zhi-Qiang;CHENHao;WANG Peng(Department of Integrative Oncology,Fudan University Shanghai Cancer Center,Shanghai(200032);Department of Oncology,Shanghai Medical College,Fudan University, Shanghai(200032))

机构地区：[1]复旦大学附属肿瘤医院中西医结合科,上海200032 [2]复旦大学上海医学院肿瘤学系,上海200032

出　　处：《中国中西医结合杂志》2019年第1期107-110,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金项目(No.81673749;No.81173461;No.81072942;No.81673746);上海市中医药事业发展三年行动计划(No.ZY3-CCCX-3-3031;No.ZY3-LCPT-2-1001);上海市科委引导项目(No.15401932400);上海市卫计委杏林新星人才培养计划(No.ZY3-RCPY-2-2023)

摘　　要：中医古籍文献中并无关于胰腺及胰腺癌的具体记载,胰腺的描述散见于"散膏"、"脺"、"珑管"等记载,类似胰腺癌的记载散见于"积聚"、"伏梁"等论述中。藏象学说是中医学核心理论体系,脏腑生理功能病理特征迥异,治则治法完全不同,中医古籍中关于胰腺脏腑属性等证治理论的缺失直接影响了胰腺病包括胰腺癌在内治则治法的确定。笔者系统整理了胰腺癌的中医证治理论体系,明确了胰腺外分泌生理以合成和排泄胰液参与消化为生理功能,符合"六腑传化物而不藏"的特征,脏腑属性属腑;胰腺癌病理符合"腑病多实"的特征,以疏泄失常,易生湿生热为病理特征,治则符合"六腑以通为用,以降为和"、"六腑以通为补"的特征,以清热化湿、行气通腑为主要治则,具有重要的临床指导和参考价值。There is no specific record of pancreas and pancreatic cancer in the ancient Chinese medicine(CM) literatures. The description of pancreas is scattered in the records of "Sangao", "Cui" and "Long-guan". Similar records of pancreatic cancer are seen in "Ji-ju(accumulation)" and "Fuliang(mass located in the upper or lower abdomen). Theory of visceral outward manifestation is the core theoretical system of CM. The pathological features of the organs are very different which result the completely different therapeutic principle and method. The lack of the theory of Zang-fu viscera properties of pancreas in Chinese ancient literatures directly affects the treatment of pancreatic diseases including pancreatic cancer. This paper systematically collates the theoretical system of CM syndromes and treatment of pancreatic cancer, and clarifies that pancreatic exocrine physiology synthesizes and excretes pancreatic juice to participate in digestion as a physiological function, conforms to the characteristics of "six-Fu transmissions without accumulation",Zang-fu viscera properties of the pancrea belongs to "Fu". The pathology of pancreatic cancer is consistent with the characteristics of "Fu-viscera excess", and is characterized by qi dysfunction and prone to dampness and heat, the treatment is in line with the characteristics of "six Fu-organs unobstructed in function, to be reduced to harmony," and "six Fu-organs unobstructed as supplements". Clearing heat and resolving dampness, activating qi and purging Fu-organs are the main principles for treatment. It has important clinical guidance and reference value.

关 键 词：胰腺癌 藏象学说 腑病多实 湿热蕴结 清热化湿 

分 类 号：R273[医药卫生—中西医结合]