基于“体寒瘤热”探析恶性肿瘤的病机与治疗  

Exploring the pathogenesis and treatment of cancer based on "body coldness and tumor heat"

作　　者：唐迎港 张晓维 何兰 蒋益兰 王其美 TANG Yinggang;ZHANG Xiaowei;HE Lan;JIANG Yilan;WANG Qimei(Graduate School,Hunan University of Chinese Medicine,Changsha 410208,China;The First Hospital of Hunan University of Chinese Medicine,Changsha 410007,China;Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine,Changsha4410006,China)

机构地区：[1]湖南中医药大学研究生院,长沙410208 [2]湖南中医药大学第一附属医院 [3]湖南省中西医结合医院

出　　处：《北京中医药大学学报》2024年第7期998-1004,共7页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(No.82305329);湖南省研究生科研创新项目(No.CX20230797);全国名老中医药专家传承工作室建设项目。

摘　　要：恶性肿瘤是临床上常见的慢性疑难疾病,西医学认为,免疫与炎性微环境紊乱是恶性肿瘤产生与进展的关键病机。中医学认为,恶性肿瘤属“积聚”“癥瘕”等范畴。基于整体与局部的寒热属性及疾病不同阶段的正邪交争特点,本文提出恶性肿瘤产生与进展的“体寒瘤热”病机观,其病机特点与西医学所认为的肿瘤免疫与炎性微环境紊乱的病机内涵相契合。以此为切入点,认为肿瘤免疫微环境紊乱是“全身体寒”的微观表象,肿瘤炎性微环境失调是“局部瘤热”的形成基础。同时,提出寒热平调、顾护阳气、温肾健脾以补“体寒”,行气化湿、祛痰化瘀、解毒散结以祛“瘤热”的治疗思路,通过补其虚、祛其邪、通其滞,改善“全身体寒、局部瘤热”的寒热错杂状态,恢复阴阳平衡,以此改善微环境紊乱状态,从而提高临床疗效。Cancer is a prevalent and challenging disease that is difficult to treat.Western medicine recognizes the disruption of the immune and inflammatory microenvironment as a crucial factor in the development and progression of cancer.According to traditional Chinese medicine,cancer falls into the categories of "accumulation" and "abnormal masses".Based on the attributes of cold and heat in the overall and local conditions as well as the characteristic of the struggle between the vital qi and pathogenic factors at different stages of this disease,this article proposes the concept of " body coldness and tumor heat " to describe the pathogenesis of cancer formation and progression.This pathogenesis aligns with the disruption of the immune and inflammatory microenvironment in modern medical oncology.The article suggests a treatment approach that focuses on balancing cold and heat,nourishing and protecting yang qi,warming the kidneys,and strengthening the spleen to address the "coldness of the entire body".This approach also involves promoting qi circulation,eliminating dampness,phlegm,and stasis,and detoxifying and dispersing nodules to address the "heat in the tumor locally".By addressing deficiencies,eliminating pathogenic factors,and promoting circulation to alleviate stagnation,the aim is to restore the balance of yin and yang and improve the complex state of "coldness of the entire body" and "heat in the tumor locally".These interventions can ameliorate the disorder in the microenvironment and enhance clinical efficacy.

关 键 词：寒热错杂 正邪交争 肿瘤免疫微环境 肿瘤炎性微环境 体寒瘤热 

分 类 号：R273[医药卫生—中西医结合]