基于“辨病论治”五步探讨胰腺癌前病变辨治思路  

Thought of Diagnosis and Treatment of Pancreatic Precancerous Lesions Based on the Five Steps of Disease Differentiation and Treatment

作　　者：张传龙 刘福栋 姜晓晨 庞博[2] 花宝金[1] 朴炳奎[1] ZHANG Chuanlong;LIU Fudong;JIANG Xiaochen;PANG Bo;HUA Baojin;PIAO Bingkui(Guang′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;International Medical Department of Guan′anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]中国中医科学院广安门医院国际医疗部,北京100053

出　　处：《世界中医药》2024年第5期687-690,共4页World Chinese Medicine

基　　金：中国中医科学院科技创新工程肿瘤学重大攻关项目(CI2021A01805)——基于中医经典与人用经验胰腺肿瘤防治方药发掘方法研究;中国中医科学院科技创新工程创新团队(调气解毒肿瘤防治与转化创新团队)专项(CI2021B009)——中医古籍肿瘤相关文献整理挖掘与理论传承创新研究;北京市自然科学基金面上项目(7222296)——基于JNK信号通路探讨薏苡附子败酱散改善卵巢癌炎性微环境的机制研究。

摘　　要：中医“治未病”思想在辨治癌前病变方面具有优势,但目前胰腺癌前病变面临着诊断、治疗均不足的局面。胰腺癌前病变的辨治方法尚不完善,值得进一步探索。面对临床无症状患者时,辨病论治模式较辨证论治更具有优势。总结中医药对胰腺癌前病变的研究进展,进一步明确辨病论治模式对胰腺癌前病变的意义,提出“辨病位在肝在脾、辨病性在常在变、辨病证为积为聚、辨病机邪正盛衰、辨病势为进为退”的五步辨治思路。以期为临床防治胰腺癌前病变提供新思路,为构建胰腺癌前病变精准辨治体系提供借鉴。The concept of treating disease before its onset in TCM has advantages in the diagnosis and treatment of precancerous lesions,while the management of pancreatic precancerous lesions faces challenges in both diagnosis and treatment.The strategies for the diagnosis and treatment of pancreatic precancerous lesions are not perfected and warrant further exploration.Disease differentiation and treatment outperforms syndrome differentiation and treatment for the asymptomatic patients.This paper reviews the progress in TCM research on pancreatic precancerous lesions,clarifies the significance of disease differentiation and treatment for pancreatic precancerous lesions,proposes a five-step disease differetiation and treatment approach:judging the disease location in the liver or spleen,the disease nature being steady or changing,the syndrome being accumulation or aggregation,the disease mechanism of pathogen excess or healthy qi deficiency,and the disease tendency of progression or remission.This review aims to provide new ideas for the clinical prevention and treatment of pancreatic precancerous lesions and to serve as a reference for establishing a precise differentiation and treatment system for this disease.

关 键 词：癌前病变 辨病论治 病证结合 精准辨治 胰腺癌 中医药 治未病 临床经验 

分 类 号：R273[医药卫生—中西医结合]