基于“虚气留滞”理论从肝玄府微徵结辨治肝癌癌前病变  

Addressing hepatocellular carcinoma precursor lesions from the deficiency and stasis perspective:a liver Xuanfu micro-stasis approach

作　　者：齐鑫磊 常占杰 张海博[1] 李安娜 王梓昂 关茜 闫瑞娟 焦俊喆 李京涛 QI Xin-lei;CHANG Zhan-jie;ZHANG Hai-bo;JIAO Jun-zhe;LI Jing-tao(Shaanxi University of Chinese Medicine(Xianyang Shanxi,712000),China)

机构地区：[1]陕西中医药大学,陕西咸阳712000 [2]陕西中医药大学附属医院

出　　处：《中西医结合肝病杂志》2025年第2期138-141,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：国家自然科学基金(No.82174330,82374418);陕西省科技厅科研基金(No.2024JC-YBMS-650,2024SF-YBXM-528);陕西省科技厅创新团队(No.2022TD-55);陕西省中医药管理局(No.SZY-KJCYC-2023-049,SZY-KJCYC-2023-087);陕西省中医药管理局“双链融合”创新团队(No.2022-SLRH-LJ-002);宁夏自然科学基金(No.2023AAC03510、No.2023AAC03481)。

摘　　要：肝癌癌前病变是慢性肝病进展为肝癌的中心环节,在此阶段及时给予有效治疗,则有可能阻止肝癌癌前病变向肝癌的恶性进展。中医认为机体气血失调、脏腑亏虚所导致的肝玄府微徵结是肝癌癌前病变的典型病理状态。“虚气”以及痰、湿、瘀、毒等病理产物留滞,导致肝玄府郁滞是肝玄府微徵结形成的关键因素。该文基于“虚气”和“留滞”二者的关系对肝癌癌前病变的病机演变进行探讨,以开玄行滞为基本治则,总结其论治思路,并提出其重点在于“培元补虚、开玄行滞”,以期为肝癌癌前病变的临床诊疗提供思路。The precursor lesions of hepatocellular carcinoma(HCC)represent a critical juncture in the progression from chronic liver disease to HCC,and the timely administration of effective treatment during this phase may halt the malignant transformation into HCC.Traditional Chinese medicine(TCM)posits that the typical pathological state of these precursor lesions is rooted in the disharmony of Qi and blood,and the deficiency of the viscera,culminating in the micro-stasis of liver Xuanfu.The"deficient Qi"and the retention of pathogenic factors,such as phlegm,dampness,blood stasis and toxins,are pivotal in the formation of liver Xuanfu congestion.This manuscript explores the pathogenic evolution of HCC precursor lesions through the lens of the interplay between"deficient Qi"and"retention,"advocating for the fundamental therapeutic principle of opening Xuanfu and facilitating the resolution of stagnation.It distills the therapeutic rationale and underscores the paramount importance of"nurturing the vital essence and dispelling stagnation"with the aim of offering a clinical framework for the diagnosis and management of HCC precursor lesions.

关 键 词：肝癌癌前病变 虚气留滞 开玄府 培元补虚 

分 类 号：R735.7[医药卫生—肿瘤]