基于“阴火”理论防治肺结节结癌转化  

The prevention and treatment of lung nodules node-cancer transformation based on the theory of Yin fire

作　　者：路洁 孙铜林 周颖[1] 梁馨丹 刘华[2] LU Jie

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《中医临床研究》2024年第8期55-58,共4页Clinical Journal Of Chinese Medicine

基　　金：创新平台与人才计划——临床医学研究中心(基地)(2021SK4023);2021年度湖南中医药大学科研基金与联合基金项目(2021XJJJO47);2021年度长沙市自然科学基金项目(kq2202454)。

摘　　要：肺结节在临床中十分多见,但由于没有特异性症状且未形成瘤体,多数患者不能及时发现或没有太过重视,病情迁延日久,部分转化为癌。肺结节转化成肺癌是一个动态的过程,文章从气火的生理病理阐释气火失调的本质。气火失调的主导方面在于火,元气亏损,脾胃亏虚是肺结节发生的主因,久病气火失衡,“阴火妄动”是癌变发生的关键病机。中医阴火理论源于《黄帝内经》,文章围绕气与火之间的关系,探讨结癌转化与肿瘤血管新生之间的联系,也是对能量和代谢相互作用失稳状态变化的基本概括。阴火始于元气不足,脾胃亏虚以致水谷精微失于布散,代谢障碍,停久为痰瘀之品,与血脉相搏结,造成局部微环境变化,使肿瘤血管新生,进一步加快肺癌转化进程。阴火为肿瘤发生创造条件,为肿瘤生长提供动力,为肿瘤转移创造环境。在阴火理论指导下,立足“虚—气—火—痰—瘀—毒”病机演变过程,治疗时应调畅气机、宣散火热,散火清热利导以治标,升阳解郁以治本,提出健脾胃、补元气、泻阴火的治法,调整机体内皮细胞新陈代谢机能,达到机体的稳定状态,进而抑制肿瘤血管新生,改善肿瘤微环境,延缓结节癌变进程,从而干预肺癌的进程。Pulmonary nodules are very common in clinical practice,but because there are no specific symptoms and no tumor is formed,most patients cannot be detected in time or do not pay too much attention,and the disease is prolonged for a long time,and some of them transform into cancer.The transformation of lung nodules into lung cancer is a dynamic process,and the essence of Qi(气)and fire disorder is explained from the physiological pathology of Qi and fire.The dominant aspect of Qi and fire disorder lies in fire,and the loss of vitality and spleen and stomach are the main causes of lung nodules.The Yin(阴)fire theory is from Huangdi Neijing(《黄帝内经》).In this paper,the relationship between cancer transformation and tumor angiogenesis is explored around the relationship between Qi and fire,which is also a basic generalization of the unstable state changes of energy and metabolic interactions.Yin fire starts from the deficiency of vitality,and spleen and stomach deficiency causes water and grain essence distribution disorder,resulting in metabolic disorders.After a long stay,phlegm and stasis are formed,and they compete with blood vessels,resulting in changes in the local microenvironment,making tumor angiogenesis,and further accelerating the progress of lung cancer.Yin fire creates conditions for the occurrence of tumors,provides power for tumor growth,and creates an environment for tumor metastasis.Under the guidance of the theory of Yin fire,based on the evolution process of“deficiency-Qi-fire-phlegm-stasis-poison”,it is proposed to strengthen the spleen and stomach,replenish vitality,and purge Yin fire,so as to adjust the metabolic function of epithelial cells in the body,achieve a stable state of the body,and then inhibit tumor angiogenesis,improve the tumor microenvironment,and delay the process of nodular carcinogenesis to inhibit lung cancer.

关 键 词：肺结节 阴火理论 肿瘤血管新生 肿瘤微环境 

分 类 号：R256.1[医药卫生—中医内科学]