1.中国中医科学院广安门医院,北京市西城区北线阁5号,100032
2.中国中医科学院中医药信息研究所
3.北京市西城区证仁医院
drlinhongsheng@163.com
收稿:2023-08-03,
修回:2023-09-13,
纸质出版:2024-01-02
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刘艺,张楚楚,尹炳驿等.基于“因加而发”探讨肺结节“结癌转化”的防治[J].中医杂志,2024,65(01):39-43.
LIU Yi,ZHANG Chuchu,YIN Bingyi,et al.The Prevention and Treatment of Pulmonary Nodules “Nodule-cancer Transformation” Based on the View of “Disease with Latent Pathogen Induced by a New Pathogen”[J].Journal of Traditional Chinese Medicine,2024,65(01):39-43.
刘艺,张楚楚,尹炳驿等.基于“因加而发”探讨肺结节“结癌转化”的防治[J].中医杂志,2024,65(01):39-43. DOI: 10.13288/j.11-2166/r.2024.01.008.
LIU Yi,ZHANG Chuchu,YIN Bingyi,et al.The Prevention and Treatment of Pulmonary Nodules “Nodule-cancer Transformation” Based on the View of “Disease with Latent Pathogen Induced by a New Pathogen”[J].Journal of Traditional Chinese Medicine,2024,65(01):39-43. DOI: 10.13288/j.11-2166/r.2024.01.008.
“因加而发”作为《黄帝内经》所载的发病机理之一,将新邪引动故邪致病与新故合邪致病涵盖其中。基于此,认为肺结节“结癌转化”之变实为本元亏虚的基础上,新邪诱发痰凝、气滞、血瘀、毒结等故邪,正气无力驱邪外出,久羁为患,变生癌浊,日久发为癌瘤。故临床在癌毒未成、癌毒氤氲、癌变已成3个阶段治疗的基础上,采用清、透、散、补、和、化六法,标本兼顾,将肺结节治疗窗口前移,攻邪于毒未鸱张亢盛之时,扶正于正气尚未衰败之际,延缓肺结节癌变进程,为中医防治肺结节“结癌转化”提供思路。
As one of the pathogenic mechanisms contained in
The Inner Canon of Yellow Emperor
(《黄帝内经》), “disease with latent pathogen induced by a new pathogen” means that the induced new pathogen resulted to a combination of the latent previous pathogen and the new pathogen, which caused the disease. Based on this, it is believed that the change of “nodule-cancer transformation” of pulmonary nodules is actually based on the deficiency of original
qi
, and the new pathogen induces the latent pathogens like phlegm coagulation,
qi
stagnation, blood stasis, toxicity, so healthy
qi
can not drive the pathogens out, and the long-time detention generated into cancerous turbidity, and deve-loped into cancerous tumour at the end. Therefore, based on the three-stage treatment of unformed cancer, dense cancerous toxin, and developed cancer, the clinical practice applied six methods of clearing, expelling, dissipating, tonifying, harmonizing, and transforming, taking into account both the manifestation and root cause, moving the treatment window of pulmonary nodules forward, attacking the pathogens when the toxin was not yet overbearing, supporting the healthy
qi
before declining, delaying the process of nodules-cancer transformation, and providing ideas for the prevention and treatment of pulmonary nodules “nodule-cancer transformation” in traditional Chinese medicine.
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