从“虚瘀劫肝”论原发性肝癌中医药防治思路  

Discussion on Traditional Chinese Medicine Prevention and Treatment of Primary Liver Cancer from the Perspectiveof “Deficiency and Stasis Caused Liver Damage”

作　　者：王明刚[1] 蓝艳梅 蒋祖玲 蒙健林 刘潇[1] WANG Minggang;LAN Yanmei;JIANG Zuling;MENG Jianlin;LIU Xiao(The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530023,China;Guangxi University of Chinese Medicine,Nanning 530001,China)

机构地区：[1]广西中医药大学第一附属医院,广西南宁530023 [2]广西中医药大学,广西南宁530001

出　　处：《现代中医药》2024年第2期31-36,共6页Modern Chinese Medicine

基　　金：广西自然科学基金项目(2020GXNSFBA297115,2023GXNSFAA026176,2018GXNSFGA281002);广西中医药大学第一附属医院中医临床研究重点实验室,广西中医药大学博士启动基金(2020BS026);广西中医药大学第一附属医院博士启动基金(2020BS003)。

摘　　要：理论创新是中医药发展的源泉,在新理论指导下形成的新方药或新诊治方案是中医药临床防治重大疑难疾病的新突破口。正邪交争,正不胜邪是慢性疾病持续进展的内在驱力和一般特性,慢性肝病持续恶性进展囊括了:肝纤维、肝硬化、肝癌等逐步恶化的病理进程。其在遵循中医“正不胜邪”基本病机的基础也必须有其特殊性和指向性,也可理解为在慢性肝病持续进展的病理状态下将一般性的病机进行指向性和特征性的阐发。肝正虚主要是指维持正常肝再生修复的相关机制和途径异常或紊乱,肝邪胜则是指肝损伤因素持续存在及其下游触发的恶性肝再生状态进行性亢进;而“瘀”作为正邪交争过程中产生的最主要病理产物也在不断推动疾病的恶性发展。在此基础上,从“虚瘀劫肝”论肝癌的病理新认识及补虚(补肾生髓、健脾)祛瘀(疏肝、柔肝、化肝)阻断慢性肝病持续恶性进展以防治肝癌的基本思路,期望有益于疑难肝脏病症的临床防治。Theoretical innovation is the source of the development of traditional Chinese medicine,and new prescriptions or diagnosis and treatment plans formed under the guidance of new theories are new breakthroughs in the clinical prevention and treatment of major difficult diseases in traditional Chinese medicine.The conflict between healthy and evil,evil is superior to healthy,is the inherent driving force and general characteristic of the continuous progression of chronic diseases.The continuous malignant progression of chronic liver disease includes pathological processes such as liver fibrosis,cirrhosis,and liver cancer,which gradually deteriorate.On the basis of following the basic pathogenesis of traditional Chinese medicine,which emphasizes the principle of“healthy surpasses evil”,it must also have its specificity and directionality.It can also be understood as the directional and characteristic elucidation of general pathogenesis in the pathological state of continuous progression of chronic liver disease.Liver deficiency mainly refers to abnormal or disordered mechanisms and pathways related to maintaining normal liver regeneration and repair,while liver pathogenic excess refers to the progressive hyperactivity of malignant liver regeneration triggered by the continuous existence of liver injury factors and downstream triggers;And“blood stasis”,as the most important pathological product produced in the process of the conflict between healthy and evil,is constantly promoting the malignant development of the disease.On this basis,a new pathological understanding of liver cancer is discussed from the perspective of“deficiency and stasis damage liver”,as well as the basic idea of tonifying deficiency(tonifying the kidney,nourishing the marrow,and strengthening the spleen)and removing blood stasis(soothing the liver,softening the liver,and transforming the liver)to prevent and treat the continuous malignant progression of chronic liver disease.It is expected to be beneficial for the clinical prevention a

关 键 词：原发性肝癌 正邪交争 补肾调肝治脾 虚瘀劫肝 肝再生 理论创新 

分 类 号：R223.1[医药卫生—中医基础理论]