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原发性多发肺结节"炎癌转化"机制探讨

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  • 国家科技期刊平台
  • NETL
  • NSTL
  • 万方数据
原发性多发肺结节发病率较高。计算机断层成像观察中发现，随时间推移，肺结节会出现增大增多的变化。术后的病理学检查结果包括慢性炎症、腺瘤样改变、原位癌、微浸润癌、浸润癌等多种病理形态。随着病程的延长和外界因素的刺激，多发肺结节存在"炎癌转化"的可能性。湿痰瘀停聚是"炎癌转化"的基础，正气亏耗是"炎癌转化"的关键，气虚阳虚为正气亏耗的根本，情志郁结、湿痰瘀化毒为"炎癌转化"的动力。"炎癌转化"过程中存在正邪交争、湿痰瘀消长，邪长正消，湿痰瘀停聚增多、正气亏耗则结节增大增多、恶性度增加，呈现出炎 不典型性增生→癌的动态过程;正长邪消、湿痰瘀消散吸收则结节消退、癌变进程逆转，急性炎症刺激等外界激惹可加速多发肺结节"炎癌转化"进程。
Discussion on the mechanism of the"inflammation-cancer transformation"in primary multiple pulmonary nodules
Primary multiple pulmonary nodules have a high incidence,and the size and number of pulmonary nodules on computed tomography images increase with time.Postoperative pathology of multiple pulmonary nodules shows chronic inflammation,adenomatoid change,carcinoma in situ,microinvasive carcinoma,infiltrating carcinoma,and other forms.There is a possibility of"inflammation-cancer transformation"in multiple pulmonary nodules with prolonged time and external irritation.The accumulation of dampness phlegm and blood stasis is the basis of the theory of"inflammation-cancer transformation."Healthy qi deficiency is the key to the"inflammation-cancer transformation."Qi and yang deficiency are the root cause of healthy qi depletion.Emotional depression,dampness,phlegm,and blood stasis transforming into toxins provide the impetus for"inflammation-cancer transformation."There are struggle between healthy qi and evil qi,and waxing and waning of dampness,phlegm and blood stasis in the process of"inflammation-cancer transformation."The dampness phlegm and blood stasis will increase when evil qi increases and healthy qi decreases.In contrast,the size,number,and malignancy of nodules will increase during healthy qi deficiency,showing a dynamic shift from inflammation to atypical adenomatous hyperplasia to cancer.The dampness phlegm and blood stasis will be absorbed as the healthy qi increases and evil qi decreases so that lung cancer can be reversed.External irritation,such as acute inflammatory stimulation,may accelerate the transformation of"inflammation-cancer"in multiple pulmonary nodules.

primary multiple pulmonary nodulesinflammation-cancer transformationhealth qi deficiencyemotional depressiondampness phlegm and blood stasis accumulationpreventive treatment of disease

李梦乾、张晓梅、姜良铎、赖宇鑫

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北京中医药大学东方医院 北京 100078

北京中医药大学东直门医院

原发性多发肺结节 炎癌转化 正气亏耗 情志郁结 湿痰瘀停聚 治未病

首都卫生发展科研专项北京中医药大学2024年基本科研业务费"揭榜挂帅"项目

2020-2-42022024-JYB-JBZD-009

2024

10.3969/j.issn.1006-2157.2024.10.004

北京中医药大学学报
北京中医药大学

北京中医药大学学报

CSTPCD北大核心
影响因子：1.568
ISSN：1006-2157
年,卷(期)：2024.47(10)