基于“痞坚之处,必有伏阳”理论探讨非小细胞肺癌术后复发转移的防治  

Discussion on the prevention and treatment of postoperative recurrence and metastasis of non-small cell lung cancer based on the "where there is mass hardness,there must be latent yang" theory

作　　者：李经蕾 胡帅航 侯炜[1] LI Jinglei;HU Shuaihang;HOU Wei(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院广安门医院,北京100053

出　　处：《北京中医药大学学报》2025年第2期246-252,共7页Journal of Beijing University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(No.82074239);中央高水平中医医院临床科研业务费项目(No.HLCMHPP2023085);国家中医药管理局中医药创新团队及人才支持计划项目(No.ZYYCXTD-C-202205);中国中医科学院科技创新工程重大攻关项目(No.CI2021A01801);中国中医科学院中央级公益性科研院所基本科研业务费项目(No.ZZ15-XYPT-16);中国中医科学院科技创新工程项目(No.CI2021B009)。

摘　　要：非小细胞肺癌术后辅助治疗后的患者出现局部复发和远处转移一直是临床治疗的痛点和难点。中医药在防治肺癌术后复发转移方面优势明显。中医学认为,“痞坚之处,必有伏阳”,与非小细胞肺癌术后复发转移有着明显的关联性。“痞坚”与肺部肿物盘根错节、质硬如岩及生长过程中常引发疼痛的病理特点相符合;“伏阳”即由潜伏邪气闭阻等因素引起病理之阳郁结不散的状态。非小细胞肺癌术后患者,虽然“痞坚”被切除,但潜伏在机体的虚、郁、瘀、毒之邪近似“伏阳”状态,这为术后复发转移新“痞坚”的形成创造了病态微环境。本文发挥“痞坚之处,必有伏阳”理论,进一步引申“痞坚”与“伏阳”的内涵,结合团队临证经验,提出以扶正培本、活血化瘀、解毒抗癌之法改善患者免疫、缺氧、炎症等病态微环境,圆机活法防治术后复发转移,进一步丰富了肺癌术后复发转移的防治策略。Local recurrence and distant metastasis in patients after postoperative adjuvant therapy for non-small cell lung cancer remain clinical challenges.Traditional Chinese medicine demonstrates notable advantages in preventing and managing postoperative recurrence and metastasis in lung cancer.The traditional Chinese medicine principle of "where there is mass hardness,there must be latent yang" aligns closely with non-small cell lung cancer recurrence and metastasis after surgery.The term "mass hardness" describes the dense,rock-like pathology of the lung mass,which often causes pain during growth,and "latent yang" refers to pathological yang energy that remains unexpressed owing to the obstruction of latent evils and other factors such as latent evil qi.Even after surgical removal of the primary mass,this "latent yang" may persist,representing a residual microenvironment conducive to recurrence and metastasis.In this study,the "where there is mass hardness,there must be latent yang" theory is used to investigate the relationship between "mass hardness" and "latent yang." By strengthening the lung and vital qi,promoting blood circulation,removing stasis,detoxifying,and using anti-cancer herbs,this approach aims to modulate the immune microenvironment,reduce hypoxia,and prevent inflammation.These therapeutic strategies enrich preventive and treatment options of traditional Chinese medicine for postoperative recurrence and metastasis in lung cancer.

关 键 词：非小细胞肺癌 复发转移 痞坚 伏阳 手术 

分 类 号：R273[医药卫生—中西医结合]