从痰刍议腺瘤性结直肠息肉的论治  

Discussion on the treatment of adenomatous colorectal polyp based on“phlegm”

作　　者：张涛[1] 丁宁 罗吉[2] 罗宏标[1] 罗燕[2] 何永恒 ZHANG Tao;DING Ning;LUO Ji;LUO Hongbiao;LUO Yan;HE Yongheng(Hunan University of Chinese Medicine,Changsha 410208,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南省中医药研究院附属医院,湖南长沙410006

出　　处：《陕西中医》2022年第11期1596-1599,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(82004312);湖南省自然科学基金资助项目(2021JJ30419,2021JJ30421);湖南省卫生健康委科研计划项目(20201066);湖南省中医药科研计划项目(2021017,2021248);长沙市科技局重点项目(KH2201062)。

摘　　要：腺瘤性结直肠息肉是结直肠息肉中最常见的类型,也是结直肠癌最主要的癌前病变。痰是结直肠息肉的重要致病因素,也是腺瘤性结直肠息肉癌化的主要因素,更是大肠癌转移的核心病机。基于中医学基础理论及结直肠息肉的特点,笔者发现痰与腺瘤性结直肠息肉的临床表现密切相关,并且参与普通良性息肉、腺瘤性息肉与结直肠癌发生、发展的全过程,为此提出将“普通息肉-腺瘤性息肉”的病机演变过程概括为“痰饮-痰湿-痰核-痰毒”,“腺瘤性结直肠息肉-腺癌”的演变病机为“痰毒凝结成癌”,即“痰毒-癌”。从痰探讨腺瘤性结直肠息肉的定义、病因病机、癌化、转移以及治疗方法,以阐述“痰”在结直肠息肉中的重要作用,丰富中医痰病学说,同时为临床治疗腺瘤性结直肠息肉提供新思路。Adenomatous colorectal polyp is the most common type of colorectal polyps,and it is also recognized as the main precancerous lesion of colorectal carcinoma.Sputum is not only an important pathogenic factor for the formation of colorectal polyps,but also the main factor for the carcinogenesis of adenomatous colorectal polyps,and the core pathogenesis of colorectal carcinoma metastasis.Based on the basic theory of traditional Chinese medicine and the characteristics of colorectal polyps,the author found that sputum is closely related to the clinical manifestations of adenomatous colorectal polyps,and participates in the whole process of the occurrence and development of ordinary benign polyps,adenomatous polyps and colorectal carcinoma.Therefore,it is proposed to summarize the pathogenesis evolution process of“ordinary polyps-adenomatous polyps”as“phlegm drink-phlegm dampness-phlegm nucleus-phlegm toxin”,the pathogenesis of“colorectal adenoma adenocarcinoma”is“phlegm toxin coagulates into cancer”,that is,“phlegm toxin-carcinoma”.This paper discusses the definition,etiology,pathogenesis,formation,carcinogenesis,metastasis and treatment of adenomatous colorectal polyps from phlegm,in order to elaborate the important role of“phlegm”in colorectal polyps in more detail,enrich the theory of phlegm disease in traditional Chinese medicine,and provide new ideas for early prevention and early treatment of adenomatous colorectal polyps in clinic.

关 键 词：腺瘤性结直肠息肉 结直肠息肉 结直肠癌 痰 病因病机 

分 类 号：R735.37[医药卫生—肿瘤]