| 摘要: |
| 结直肠癌是常见消化道恶性肿瘤之一，具有起病隐匿、易转移复发、预后不良等特点。在中医学理论中，结直肠癌多属“积聚”“癥瘕”等范畴，其病机核心为正气亏虚、癌毒内生、毒瘀互结。文章在继承“癌毒”理论的基础上，提出“癌毒-态靶”辨证新框架，将结直肠癌的病机演化过程概括为由浊毒内生、伏毒内扰到癌毒质变的三阶段动态传变，分别对应不同病理状态，并建立“靶证-靶方-靶药”三级结构，形成“以态定法、以靶用药”的精准辨治思路。并以固本消积颗粒为例，系统阐释其益气健脾、清热解毒、活血化瘀、软坚散结等作用机制，结合现代药理学研究，揭示其通过调节肠道菌群、改善能量代谢、逆转免疫抑制、抑制血管生成等多环节、多靶点干预结直肠癌进展的内在机制。 |
| 关键词: 结直肠癌 “癌毒-态靶”辨证 浊毒 伏毒 癌毒 固本消积颗粒 中医药干预 |
| DOI： |
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| Traditional Chinese medicine theory of Guben Xiaoji Granule in treatment of colorectal cancer based on the “cancer toxin-state-target” syndrome differentiation framework |
| PENG Wei,ZHANG Jingting,LIU Zhuo,ZENG Puhua |
| (Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine，Changsha 410006，Hunan，China;Hunan University of Chinese Medicine，Changsha 410208，Hunan，China) |
| Abstract: |
| Colorectal cancer （CRC） is one of the common malignant tumors of the digestive tract，characterized by insidious onset，frequent metastasis and recurrence，and poor prognosis. In traditional Chinese medicine theory，CRC largely falls within the categories such as “accumulation” and “abdominal mass”，with the core pathogenesis of deficiency of vital Qi，internal generation of cancer toxin，and intermingled toxin and blood stasis. Based on the theory of “cancer toxin”，this article proposes a novel “cancer toxin-state-target” syndrome differentiation framework which summarizes the pathogenic evolution of CRC into a dynamic process with three stages of internal generation of turbid toxin，disturbance by latent toxin，and qualitative transformation of cancer toxin，each corresponding to different pathological states. Furthermore，it establishes a three-tier structure of “target syndrome-target prescription-target traditional Chinese medicine”，forming a precise syndrome differentiation-based treatment method of “determining therapeutic methods based on state and administering traditional Chinese medicine targeting specific pathogens”. In addition，taking Guben Xiaoji Granule as an example，the article systematically elaborates on its mechanisms of action such as tonifying Qi and strengthening the spleen，clearing heat and detoxicating，activating blood circulation and resolving stasis，and softening hard mass and resolving static blood，and with reference to modern pharmacological research，it reveals the mechanisms of Guben Xiaoji Granule in intervening against the progression of CRC through multiple targets and links such as regulating gut microbiota，improving energy metabolism，reversing immunosuppression，and inhibiting angiogenesis. |
| Key words: colorectal cancer “cancer toxin-state-target” syndrome differentiation turbid toxin latent toxin cancer toxin Guben Xiaoji Granule traditional Chinese medicine intervention |
