1.中国中医科学院广安门医院,北京市西城区北线阁5号,100053
2.中国中医科学院研究生院
3.北京中医药大学
4.陕西中医药大学研究生院
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收稿:2025-01-20,
修回:2025-02-20,
纸质出版:2025-07-17
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吴佳禾,崔慕瑶,陈雪等.基于寒气生积探讨炎症性肠病炎-癌转化辨治思路[J].中医杂志,2025,66(14):1489-1494.
WU Jiahe,CUI Muyao,CHEN Xue,et al.Exploration on the Syndrome Differentiation and Treatment Strategies for Inflammation-Cancer Transformation in Inflammatory Bowel Disease Based on the Theory of Cold Qi-Induced Accumulation[J].Journal of Traditional Chinese Medicine,2025,66(14):1489-1494.
吴佳禾,崔慕瑶,陈雪等.基于寒气生积探讨炎症性肠病炎-癌转化辨治思路[J].中医杂志,2025,66(14):1489-1494. DOI: 10.13288/j.11-2166/r.2025.14.013.
WU Jiahe,CUI Muyao,CHEN Xue,et al.Exploration on the Syndrome Differentiation and Treatment Strategies for Inflammation-Cancer Transformation in Inflammatory Bowel Disease Based on the Theory of Cold Qi-Induced Accumulation[J].Journal of Traditional Chinese Medicine,2025,66(14):1489-1494. DOI: 10.13288/j.11-2166/r.2025.14.013.
认为“寒气生积”概括了炎症性肠病向结直肠癌转化的病机特点。寒邪或为始动因素,初犯肠道则气机郁滞,留伏日久则困阻中焦,终致寒痰瘀互结成积。结合其渐进性演变过程,将炎症性肠病炎癌转化分为活动期、缓解期和癌变期,其中活动期病机以寒气生郁、湿热蕴肠为主,缓解期病机为寒气困脾、运化失司,癌变期病机包括寒郁生积、寒痰化积、寒瘀成积。据此制定治法:活动期以行气解郁、寒热并调为法,缓解期重在温阳散寒、补气健脾,癌变期分别采用行气散寒、温化寒痰及温阳散瘀以消积,以期截断炎症性肠病炎-癌转化进程。
It is proposed that cold
qi
-induced accumulation encapsulates the core pathogenesis of the inflammation-cancer transformation in inflammatory bowel disease (IBD). Cold pathogens may serve as the initiating factor. When first invading the intestines, cold pathogens obstruct the flow of
qi
; over time, the lingering cold impairs the middle
jiao
(焦), eventually leading to the accumulation of cold-phlegm and blood stasis. Based on the progressive nature of this transformation, the process can be divided into three stages, active stage, remission stage, and carcinogenic stage. In the active stage, the main pathogenesis involves stagnation of cold
qi
and accumulation of damp-heat in the intestines; in the remission stage, cold
qi
impairs the spleen, disrupting its transport and transformation functions; and in the carcinogenic stage, the mechanisms include cold-induced accumulation, phlegm accumulation from cold, and stagnation of cold and blood stasis. Accordingly, the treatment strategies are proposed.In the active stage, regulating
qi
, relieving stagnation, and harmonizing cold and heat; in the remission stage, warming
yang
, dispersing cold, tonifying
qi
, and strengthening the spleen; and in the carcinogenic stage, promoting
qi
circulation, dispersing cold, resolving phlegm, activating
yang
, and eliminating stasis to remove accumulation. These approaches aim to interrupt the transformation of IBD into colorectal cancer.
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