从“内毒致病”探讨克朗凯特-卡纳达综合征的病机及治疗  

Exploration of the pathogenesis and treatment of Cronkhite-Canada syndrome from the perspective of"endogenous toxins cause the disease"

作　　者：苏坤涵 黄玉珍[1] 刘万里 SU Kunhan;HUANG Yuzhen;LIU Wanli(Nanjing Integrated Traditional Chinese and Western Medicine Hospital,Nanjing University of Traditional Chinese Medicine,Nanjing 210014,China;Nanjing First Hospital,Nanjing 210006,China)

机构地区：[1]南京中医药大学附属南京市中西医结合医院,南京210014 [2]南京市第一医院

出　　处：《北京中医药大学学报》2024年第3期407-411,共5页Journal of Beijing University of Traditional Chinese Medicine

基　　金：江苏省中医药科技发展计划项目(No.YB2020030);南京市卫生科技发展重点项目(No.ZKX21057)。

摘　　要：克朗凯特-卡纳达综合征是以消化道多发息肉和外胚层改变为主要特征的疾病,其病因及发病机制尚不完全明确。中医学认为,内毒是一类特殊的内在致病因素,是由脏腑功能失调、气血运行失常所产生,具有潜藏蛰伏、入经入络、夹痰夹瘀的特点,能够外损肌肤、内蚀脏腑、攻于手足、耗伤正气。本文从“内毒致病”角度认识克朗凯特-卡纳达综合征的病机,认为脾虚湿热、湿毒内蕴是其发病基础,痰瘀毒结是胃肠道息肉弥漫性生长的病理本质,“湿毒-痰瘀毒-癌毒”的内毒转化过程可能是癌变发生的潜在机制。治疗克朗凯特-卡纳达综合征应以健脾、除湿、解毒为治疗原则,其中,健脾是基础,除湿是重点,解毒是关键,采用健脾渗湿、利湿解毒、化痰祛瘀等治法,辅以调理偏颇体质,注重中西医结合治疗。Cronkhite-Canada syndrome is a disease characterized by multiple polyps and changes in the ectoderm of the digestive tract,but its etiology and pathogenesis have not been completely elucidated.Endogenous toxins are a special class of intrinsic pathogenic factors,which are released upon visceral dysfunction and abnormal movement of qi and blood.Endogenous toxins can hide deeply in the body,they can enter the meridians and collaterals,and they can be mixed with phlegm and blood stasis.Endogenous toxins can damage the skin externally,corrode the internal organs,attack hands and feet,and damage the vital qi.The pathogenesis of Cronkhite-Canada syndrome can be understood from the perspective of"endogenous toxins cause the disease".Dampness-heat due to spleen deficiency and dampness toxin accumulation are the fundamental causes of Cronkhite-Canada syndrome.The mutual fusion of phlegm toxin and blood stasis toxin is the pathological essence of the diffuse growth of gastrointestinal polyps in Cronkhite-Canada syndrome.The internal toxin transformation process of"dampness toxin-phlegm stasis toxin-cancer toxin"may be a potential mechanism for the occurrence of cancer.The treatment of Cronkhite-Canada syndrome should be based on the principle of strengthening the spleen,removing dampness,and detoxification.Among them,strengthening the spleen is the foundation,removing dampness is the key,and detoxification is the core.The treatment of Cronkhite-Canada syndrome can be achieved through methods such as strengthening the spleen and infiltrating dampness,promoting diuresis and detoxification,resolving phlegm,and removing blood stasis.At the same time,correcting the patient's biased constitution should be used as an auxiliary treatment method,and treatment based on a combination of traditional Chinese and western medicine should be emphasized.

关 键 词：克朗凯特-卡纳达综合征 内毒致病 息肉 病机 治疗 

分 类 号：R259[医药卫生—中西医结合]