从"虚、郁、滞、瘀"论肠炎-癌转化中医核心病机的生物学内涵
Discussion on the Biological Connotation of Core Pathogenesis in Traditional Chinese Medicine Regrading Enteritis-Cancer Transformation from"Deficiency,Depression,Stagnation,and Stasis"
郑国银 1张旖晴 2王欣 2彭浩 1杨洋 2苏晓兰 2魏玮2
作者信息
- 1. 海军军医大学中医系,上海 200433;海军军医大学第一附属医院,上海 200433
- 2. 中国中医科学院望京医院,北京 100102
- 折叠
摘要
肠道从正常黏膜至癌变病程较为漫长,始于炎性状态,进展至癌前病变和癌前状态,终于结肠癌,简称结肠炎-癌转化类疾病.在肠道炎-癌转化类疾病进程中,所呈现"虚、郁、滞、瘀"核心病机与机体的神经、免疫状态以及平衡失调诱发的炎症反应密切相关.脾胃虚弱,炎症始生,郁化促炎,脑肠互损,气血运行不畅,肠腑痰浊内生,气滞痰凝血瘀,初未能成积聚,留滞不去,乃成积聚.从现代生物学角度而言,辅助性T细胞(T helper cell,Th)17/调节性T细胞(regulatory T cell,Treg)介导的促炎因子与抗炎因子释放,影响肠道微环境内肠道菌群结构的动态平衡,通过神经免疫等上传至大脑中枢,脑肠相互作用,在内外因的刺激下,其中某一环境平衡失调,就会造成局部和整体的失衡,诱发炎症逐步发展至不可控状态,驱动基因突变形成癌症.围绕"虚、郁、滞、瘀"核心病机,从健运脾胃入手,缓解炎症,行滞化瘀,未癌先治炎,阻断炎-癌转化,能为肠道炎-癌转化疾病的临床防治提供思路借鉴.
Abstract
The process of intestinal transformation from normal mucosa to cancer is relatively long,starting from inflammatory state,progressing to precancerous lesions and precancerous state,and finally to colon cancer,abbreviated as enteritis-cancer transformation disease.In the process of enteritis-cancer transformation,the core pathogenesis of"deficiency,depression,stagnation,and stasis"is closely related to the nervous and immune status of body,as well as the inflammatory response induced by imbalance.Weakness of the spleen and stomach leads to inflammation,depression promotes inflammation,brain and intestine damage mutually,qi and blood circulation runs not fluently,phlegm generates in the intestine,resulting in qi stagnation,phlegm coagulation,and blood stasis.At the beginning,accumulation cannot be formed,and stagnation cannot be eliminated,resulting in accumulation.From the perspective of modern biology,the release of pro-inflammatory and anti-inflammatory factors mediated by T helper cell(Th)17/regulatory T cell(Treg)affects the dynamic balance of gut microbiota structure within the intestinal microenvironment,which is transmitted to the cerebral center through neuroimmune mechanisms,and brain interacts with gut.Under the stimulation of internal and external factors,the imbalance of one environment can cause local and overall imbalance,leading to the gradual development of inflammation to an uncontrollable state and driving gene mutations to form cancer.Focusing on the core pathogenesis of"deficiency,depression,stagnation,and blood stasis",starting from strengthening the spleen and stomach,relieving inflammation,promoting stagnation and blood stasis,treating inflammation before cancer,and blocking the transformation from inflammation to cancer can provide ideas and references for the clinical prevention and treatment of enteritis-cancer transformation diseases.
关键词
积聚/炎-癌转化/脾胃虚弱/郁滞/血瘀/神经免疫Key words
accumulation/inflammation-cancer transformation/weakness of the spleen and stomach/stagnation/blood stasis/neuroimmunity引用本文复制引用
基金项目
国家自然科学基金面上项目(81573653)
国家中医药管理局第七批全国名老中医药专家学术经验传承项目(2021-272)
国家重点研发计划"中医药现代化研究"专项(2022YFC3500503)
上海市科技创新行动计划项目(20S21900400)
上海市卫健委中医药平台支撑科研专项(2024PT006)
出版年
2024
国家科技期刊平台
NSTL
万方数据