浅析肠癌肝肺转移病因病机  

Exploration on the Etiology and Pathogenesis of Liver and Lung Metastasis in Colorectal Cancer

作　　者：陈欣 郑琦[1] 席玉棚 王成磊 郭秋均[1] 郑红刚[1] 花宝金[1] CHEN Xin;ZHENG Qi;XI Yupeng;WANG Chenglei;GUO Qiujun;ZHENG Honggang;HUA Baojin(Department of Oncology,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Department of General Internal Medicine,Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Graduate School,Shaanxi University of Chinese Medicine,Xianyang 712046 Shaanxi,China)

机构地区：[1]中国中医科学院广安门医院肿瘤科,北京100053 [2]中国中医科学院广安门医院综合科,北京100053 [3]陕西中医药大学研究生院,陕西咸阳712046

出　　处：《中医肿瘤学杂志》2024年第6期38-44,共7页Journal of Oncology in Chinese Medicine

基　　金：国家自然科学基金面上项目(编号:82174464);北京市自然科学基金面上项目(编号:7172186);中央高水平中医医院临床研究和成果转化能力提升项目(编号:HLCMHPP20230);中国中医科学院科技创新工程项目(编号:CI2021A01804);中国中医科学院广安门医院临床医学研究中心建设专项经费项目(编号:2022LYJSZX14)。

摘　　要：大肠癌的肝肺转移主要归因于脏腑功能失调,尤其是大肠与肝、肺二脏之间的关联。癌毒初始聚积于大肠,随着病情进展,沿经脉扩散至肝脏和肺部。若肝气郁结或肝血亏虚,则气血瘀滞,癌毒易于积聚并扩散至肝。肺主一身之气,大肠糟粕积聚,传导失职致使肺宣发肃降失常,易于侵袭入肺,在此过程中,或因痰湿阻滞气机,瘀血阻碍血行,或因肝气犯肺,气血运行不畅,进一步助长癌毒的扩散和转移。本文从肝通大肠的经络、五行及藏象内涵角度和肺合大肠的脏腑、经络、体用及气化关系角度,阐述大肠癌肝肺转移发生的具体病因病机,临床上对预防大肠癌患者发生肝肺转移、遏制疾病进展意义深远。The primary cause of liver and lung metastasis in colorectal cancer is the malfunctioning of internal organs,particularly the connections between the large intestine and the liver and lung.Initially,cancer toxin accumulates in the large intestine.As the disease progresses,it spreads to liver and lung along the meridians.When liver qi stagnates or liver blood lacks,it causes stasis of both qi and blood,making it easier for cancer toxin to accumulate and spread to liver.Lung governs the body's qi.When large intestine accumulates dregs and its conduction function fails,it disrupts the normal descending and dispersing functions of lung,making it susceptible to invasion.During this process,phlegm-dampness may obstruct the qi mechanism,and blood stasis may hinder blood flow,or liver qi attacking lung may impair the circulation of qi and blood,further promoting the spread and metastasis of cancer toxin.This article explored the specific etiology and pathogenesis of liver and lung metastasis in colorectal cancer from the perspectives of the meridian,five elements,and organ manifestation connotation of liver connecting to large intestine,as well as the organ,meridian,body function,and qi transformation relationship of lung and large intestine in pair.It has profound clinical significance in preventing liver and lung metastasis and curbing disease progression in colorectal cancer patients.

关 键 词：大肠癌转移 肝通大肠 肺合大肠 藏象 气化 相辅相助 互克互制 

分 类 号：R273[医药卫生—中西医结合] R735.3[医药卫生—中医肿瘤科]