基于“态靶因果”探析慢性胰腺炎“炎癌转化”的病机演变与论治策略  

Analysis of pathogenesis evolution and therapeutic strategies for"inflammation-cancer transformation"in chronic pancreatitis based on"state-target-cause-result"

作　　者：戴云飞 尚东[1,2,3] 项红 关溪[1,3] 赵亮 白长川(指导) DAI Yunfei;SHANG Dong;XIANG Hong;GUAN Xi;ZHAO Liang;BAI Changchuan(Advisor)(The First Affiliated Hospital of Dalian Medical University,Dalian 116011,China;Institute/College of Integrative Medicine,Dalian Medical University,Dalian 116044,China;Liaoning Provincial Center for Integrated Traditional Chinese and Western Medicine Therapy for Biliary and Pancreatic Diseases,Dalian 116011,China)

机构地区：[1]大连医科大学附属第一医院,大连116011 [2]大连医科大学中西医结合研究院/学院 [3]辽宁省胆胰疾病中西医结合治疗中心

出　　处：《北京中医药大学学报》2024年第10期1360-1366,共7页Journal of Beijing University of Traditional Chinese Medicine

基　　金：第七批全国老中医药专家学术经验继承工作(国中医药办人教函〔2021〕272号);兴辽英才计划(No.XLYC2212013)。

摘　　要：“态靶因果”是在中医整体观基础上结合西医学研究进展提出的一种宏观与微观辨证相结合的临床辨治新思维。慢性胰腺炎“炎癌转化”是胰腺与多种病理因素、多个对象相互影响的复杂病理过程,涉及多种稳态的失衡。将慢性胰腺炎“炎癌转化”这一微观过程作为“靶”,将在慢性炎症状态下可能诱导其发生的各类因素作为“态”。将慢性胰腺炎“炎癌转化”概括为阴阳失衡,气运失调,湿热瘀痰浊内生而滞,胶结不解,因滞而虚,虚实夹杂,癌毒内生的过程。提出从“态”这一更为宏观的角度阐述慢性胰腺炎“炎癌转化”的病机演变与干预策略,即通过减少“态”的失衡对“靶”的影响,建立起胰腺-免疫-微生物共平衡状态的思维,以期为中医药及西医学对于慢性胰腺炎“炎癌转化”机制与药物研发的探索拓宽思路。"State-target-cause-result"is a new clinical theory combining macroscopic and microscopic syndrome differentiation based on the holistic view of traditional Chinese medicine combined with Western medical research.The"inflammation-cancer transformation"of chronic pancreatitis is a complex pathological process that is associated with the interaction between the pancreas and various pathological factors and multiple objects,involving the imbalance of multiple homeostasis.The microscopic process of"inflammation-cancer transformation"in chronic pancreatitis is the"target,"whereas various factors that could induce its occurrence under chronic inflammatory conditions are the"state."The"inflammationcancer transformation"of chronic pancreatitis is summarized as yin and yang imbalance,qi movement disorder,endogenous dampness,heat,blood stasis,and turbid phlegm stagnation,unresolved congestion resulting in deficiency caused by stagnation,intermingled deficiency and excess,and internal cancer toxin generation.This paper elucidates the pathogenesis and intervention strategies of the"inflammation cancer transformation"of chronic pancreatitis from a macro perspective of"state,"focusing on reducing the impact of"state"imbalance on the"target"to establish a balanced pancreas-immune-microbiota state.The aim is to broaden the theory for exploring the mechanism and drug development related to chronic pancreatitis"inflammation-cancer transformation"in both traditional Chinese and Western medicine.

关 键 词：态靶因果 慢性胰腺炎 炎癌转化 胰腺癌 治未病 

分 类 号：R256.3[医药卫生—中医内科学]