基于“阳化气,阴成形”论治中晚期大肠癌  

Treating Advanced Colorectal Cancer Based on the Theory of"Yang Transforming Qi While Yin Constituting Form"

作　　者：彭瑜 张京华 潘元灿 刘振国 李春华 李增云 PENG Yu;ZHANG Jinghua;PAN Yuancan;LIU Zhenguo;LI Chunhua;LI Zengyun(Shandong University of Traditional Chinese Medicine,Jinan,Shandong,China,250335;Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University,Beijing,China,100010;The Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan,Shandong,China,250001;Jinan Hospital of Integrated Traditional Chinese and Western Medicine,Jinan,Shandong,China,271100)

机构地区：[1]山东中医药大学,山东济南250335 [2]首都医科大学附属北京中医医院,北京100010 [3]山东中医药大学第二附属医院,山东济南250001 [4]济南市中西医结合医院,山东济南271100

出　　处：《河南中医》2024年第10期1518-1524,共7页Henan Traditional Chinese Medicine

摘　　要：大肠癌的发生是在“阳化气”不足的基础上,气的升降出入和推动、温煦、气化功能异常,脏腑经络气血功能障碍,精血津液输布失常,导致“阴成形”太过,产生过多的痰浊、瘀血、毒邪等阴性秽浊之物。病理性质为本虚标实、虚实夹杂,常见全身属虚而局部属实。发病初期,邪毒偏盛而正虚不显;中晚期由于癌毒耗伤人体气血津液,多出现气虚、阳虚、气血亏虚或阴阳两虚等。扶阳为治疗之本,阳气不足以心、脾和肾三脏多见,温补脾肾之阳可使机体的“阳化气”功能得以恢复。导致大肠癌的阴邪包括湿、痰、瘀、癌毒,应治以理气、化湿、燥痰、化瘀、解毒等,以消阴邪。然而,单用中医综合治疗干预中晚期大肠癌的可行性差,故常与现代医学联合,选择合适的化疗、靶向治疗、免疫疗法等,以延长生存周期,提高生存质量。The development of colorectal cancer is based on the insufficiency of"yang transforming qi,"leading to dysfunction in the rise,fall,exit,entry,propulsion,warming,and qi transformation processes,along with impaired functions of zang-fu organs,meridians,and qi-blood circulation.This results in abnormal distribution of essence,blood,and body fluid,causing an excess of"yin constituting form,"leading to an overproduction of phlegm,blood stasis,toxic pathogens,and other turbid yin substances.The pathological nature is characterized by a combination of root deficiency and branch excess,with systemic deficiency and local excess.In the early stage of the disease,pathogenic toxins are predominant,and the deficiency of healthy qi is not yet apparent.In the advanced stages,the cancerous toxins deplete the body′s qi,blood,and body fluid,often resulting in qi deficiency,yang deficiency,qi-blood depletion,or yin-yang deficiency,etc.Supporting yang is the foundation of treatment,as yang deficiency commonly involves the heart,spleen,and kidney.Warming and tonifying the yang of the spleen and kidney can help restore the body′s function of"yang transforming qi."The yin pathogens contributing to colorectal cancer include dampness,phlegm,blood stasis,and cancer toxins,which should be treated by regulating qi,resolving dampness,drying phlegm,dissolving blood stasis,and detoxifying.However,the feasibility of relying solely on TCM to treat advanced colorectal cancer is low,so it is often combined with modern medical approaches,such as chemotherapy,targeted therapy,and immunotherapy,etc.,to extend survival time and improve quality of life of patients.

关 键 词：大肠癌 中晚期 阳化气 阴成形 扶阳法 消阴法 

分 类 号：R273.353.4[医药卫生—中西医结合]