1.南京中医药大学第一临床医学院,江苏省南京市栖霞区仙林大道138号,210023
2.江苏省中医药防治肿瘤协同创新中心
3.南京中医药大学附属医院
haibocheng@njucm.edu.cn
收稿:2025-01-12,
修回:2025-04-01,
纸质出版:2025-08-02
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耿雪尘,李柳,张钦畅等.从癌毒病机时空演变探讨肠癌术后复发核心病机及防治策略[J].中医杂志,2025,66(15):1538-1542.
GENG Xuechen,LI Liu,ZHANG Qinchang,et al.Discussion on the Core Pathogenesis and Prevention and Treatment Strategy for Postoperative Recurrence of Colorectal Cancer from the Spatiotemporal Evolution of the Cancer Toxin Theory[J].Journal of Traditional Chinese Medicine,2025,66(15):1538-1542.
耿雪尘,李柳,张钦畅等.从癌毒病机时空演变探讨肠癌术后复发核心病机及防治策略[J].中医杂志,2025,66(15):1538-1542. DOI: 10.13288/j.11-2166/r.2025.15.005.
GENG Xuechen,LI Liu,ZHANG Qinchang,et al.Discussion on the Core Pathogenesis and Prevention and Treatment Strategy for Postoperative Recurrence of Colorectal Cancer from the Spatiotemporal Evolution of the Cancer Toxin Theory[J].Journal of Traditional Chinese Medicine,2025,66(15):1538-1542. DOI: 10.13288/j.11-2166/r.2025.15.005.
癌毒病机理论认为肿瘤是以癌毒为核心,多时点、多病位、邪毒交错、虚实夹杂的复合病证。肠癌术后复发是动态的时空过程,从癌毒病机时空演变探讨肠癌术后复发“脾气亏虚、湿热瘀毒”的核心病机,提出脾气亏虚继而癌毒滋长是肠癌术后复发的时间特征,湿热瘀阻促使癌毒流结是肠癌术后复发的空间规律。构建以复发前后不同时空阶段为分期的时空整体防治策略,即未复发重点在“防”,扶正健脾、清热化湿、通络解毒;已复发重点在“治”,抗癌解毒、破血消癥、调补脏腑。
According to the theory of cancer toxin pathogenesis, tumors are complex syndromes centered on cancer toxin, characterized by multiple time points and locations, interwoven pathogenic toxins, and a combination of deficiency and excess. Postoperative recurrence of colorectal cancer is a dynamic spatiotemporal process. In this paper, the core pathogenesis of postoperative recurrence of colorectal cancer, namely "defici
ency of spleen
qi
, with damp-heat stasis toxin", has been discussed based on spatiotemporal evolution of cancer toxin. It is suggested that spleen
qi
depletion leading to the proliferation of cancer toxin represents the temporal characteristic of postoperative recurrence, while the stasis of damp-heat facilitating the aggregation and spread of cancer toxin refelct its spatial pattern. This paper has constructed a holistic spatiotemporal prevention and treatment strategy according to different stages before and after recurrence. Before recurrence, the focus is on prevention, and it is suggested to rectify the healthy
qi
and fortify spleen, clear heat and resolve dampness, unblock collaterals and remove toxin. After recurrence, the focus should be on treatment, and the strategy is combating cancer and removing toxin, breaking the blood to eliminate disease, regulating and tonifying the
zang
-
fu
(脏腑) organs.
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