[1]宗铭桐,谢虹亭,席玲泽,等.基于“建中”理论探讨肿瘤营养不良病机及治法[J].陕西中医,2024,(6):794-797.[doi:DOI:10.3969/j.issn.1000-7369.2024.06.015]
　ZONG Mingtong,XIE Hongting,XI Lingze,et al.Exploring the pathogenesis and treatment of cancer related malnutrition based on “Jianzhong” theory[J].,2024,(6):794-797.[doi:DOI:10.3969/j.issn.1000-7369.2024.06.015]
点击复制

基于“建中”理论探讨肿瘤营养不良病机及治法
分享到：

《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年6期
页码:
794-797
栏目:
学术探讨
出版日期:
2024-06-05

文章信息/Info

Title:
Exploring the pathogenesis and treatment of cancer related malnutrition based on “Jianzhong” theory
作者:
宗铭桐1; 2; 谢虹亭1; 2; 席玲泽1; 2; 薛 鹏2; 朱世杰2
(1.北京中医药大学研究生院,北京 100029; 2.中国中医科学院望京医院肿瘤科,北京 100102)
Author(s):
ZONG Mingtong; XIE Hongting; XI Lingze; XUE Peng; ZHU Shijie
(Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China)
关键词:
肿瘤相关营养不良;  虚劳;  建中理论;  病机;  中焦虚寒;  辨证论治
Keywords:
Cancer related malnutrition;  Consumptive disease;  Jianzhong theory;  Pathogenesis;  Middle jiao deficiency cold;  Syndrome differentiation and treatment
分类号:
R 730.6
DOI:
DOI:10.3969/j.issn.1000-7369.2024.06.015
文献标志码:
A
摘要:
肿瘤营养不良是恶性肿瘤最常见的并发症之一,以食欲减退、消化道营养影响症状、体重减轻为主要临床表现。中医认为其属虚劳类病。追其源头,多因肿瘤瘀毒结聚、抗肿瘤治疗损伤导致中焦虚寒、肠失传化,引起五脏精气不足,渐至于机体气血阴阳虚衰。从“建中”理论出发可以认为该病的基本病机为中焦虚寒、肠失传化。在治疗上,应以温补中焦助运化为主要治法,方剂用大建中汤与参苓白术散温胃散寒、益气健脾。又因肿瘤患者病情复杂,往往还存在痰湿困脾、瘀血阻滞,所以还需开胃醒脾增摄入、化瘀散寒强功效,强调芳香化湿药物与活血化瘀药物的使用,从而达到改善患者胃肠蠕动排空功能与调整肠道紊乱菌群的目的。临床应注重胃肠道消化功能的提高,增加营养物质摄入、消化及吸收,最终实现改善患者营养状态、降低营养风险的目的。
Abstract:
Cancer related malnutrition is a common complication of malignant tumors,characterized by decreased appetite,gastrointestinal symptoms,and weight loss.Traditional Chinese medicine believes that it belongs to the consumptive disease.Tracing its source,it often occurs due to the accumulation of tumor stasis and toxins,as well as damage caused by antitumor treatment,resulting in the deficiency cold of the middle jiao and the loss of intestinal transport and digestion,causing insufficient jing and qi in the five internal organs,gradually leading to the deficiency of qi,blood,yin and yang in the body.Starting from the “Jianzhong” theory,it can be considered that the basic pathogenesis of this disease is the deficiency cold of the middle jiao and the loss of intestinal transport and digestion.In terms of treatment,the main treatment method is to warm and tonify the middle jiao to assist in transportation and digestion,and the prescription uses Dajianzhong Tang and Shenling Baizhu San to warm the stomach,dispel cold,and nourish qi and invigorate the spleen.Due to the complex condition of tumor patients,there is often phlegm dampness trapped in the spleen and blood stasis obstruction.Therefore,it is necessary to appetizing and invigorating the spleen to increase intake,dispelling cold and resolving blood stasis to increase therapeutic effect,and emphasize the use of aromatic dampness removing drugs and blood activating and stasis removing drugs.Thus achieving the goal of improving the patient's gastrointestinal peristalsis and emptying function,as well as adjusting the dysbiosis of the gut microbiota.Further improve the digestive function of the gastrointestinal tract,increase nutrient intake,digestion,and absorption,ultimately achieving the goal of improving patient nutritional status and reducing nutritional risks.

参考文献/References:

[1] 王林,丛明华,崔久嵬,等.肿瘤营养治疗的基本原则[J].肿瘤代谢与营养电子杂志,2022,9(6):727-734.
[2] 宋春花,王昆华,郭增清,等.中国常见恶性肿瘤患者营养状况调查[J].中国科学:生命科学,2020,50(12):1437-1452.
[3] LIU C A,LIU T,LI H C,et al.Nutrition impact symptoms:Noteworthy prognostic indicators for lung cancer[J].Clin Nutr,2023,42(4):550-558.
[4] MEZA V D,MARCO E,VALOS Y V,et al.Sarcopenia,malnutrition,and cachexia:Adapting definitions and terminology of nutritional disorders in older people with cancer[J].Nutrients,2021,13(3):761.
[5] 张晓峰,冯景,季飞燕,等.结直肠癌术后辅助化疗患者肠内营养不耐受影响因素及小野寺预后营养指数预测价值分析[J].陕西医学杂志,2022,51(9):1114-1117,1121.
[6] 曹子谦,李树营,任宏,等.胃癌根治术后患者营养风险筛查及其行早期肠内营养支持和肠外营养支持的效果对比[J].陕西医学杂志,2018,47(10):1272-1274,1293.
[7] 中华医学会肠外肠内营养学分会.肿瘤患者营养支持指南[J].中华外科杂志,2017,55(11):801-829.
[8] 刘俊青,韩金凤.癌性腹胀的诊疗新进展[J].光明中医,2021,36(21):3732-3735.
[9] 王程程.营养饮食干预与中医综合康复护理应用在肿瘤患者中对其生存质量的影响[J].中国农村卫生,2021,13(18):67-69.
[10] 邵状,张诏.《金匮要略》虚劳证治探析[J].中国中医基础医学杂志,2022,28(12):1934-1937.
[11] 王桂彬,庞博,朴炳奎.“劳者温之”内涵考镜[J].北京中医药大学学报,2023,46(2):191-195.
[12] 徐萍利,杜磊,杨学惠,等.杨国汉教授谈建中[J].光明中医,2021,36(11):1785-1788.
[13] 沈敏,毛叶勤,陈冯梅.恶性肿瘤患者状况与中医体质分类的相关性研究[J].中医药临床杂志,2023,35(3):540-544.
[14] 黎晓岚,潘玉真,殷东风,等.基于数据挖掘探析中医治疗恶性肿瘤相关营养不良的处方规律[J].中医临床研究,2023,15(10):61-67.
[15] 马云飞,李光达,李晓晓,等.从阳虚毒聚浅析王笑民辨治晚期肿瘤的经验[J].上海中医药杂志,2020,54(6):72-74,86.
[16] 武煜,王一同,周琴,等.左明焕教授基于“中焦为枢”治疗消化道肿瘤术后胃瘫综合征经验[J].中国医药导报,2023,20(14):142-145.
[17] 林瑞芳,俞赟丰,阳凌峰,等.基于肠道菌群探讨中医药治疗功能性消化不良研究进展[J].陕西中医,2022,43(11):1647-1650.
[18] ZHANG S,XU Z,CAO X,et al.Shenling Baizhu San improves functional dyspepsia in rats as revealed by 1H-NMR based metabolomics[J].Anal Methods,2020,12(18):2363-2375.
[19] TORU K,TAKU M,YUSUKE O,et al.Distinct effects of TU-100(daikenchuto)on long-lasting dysbiosis in the small intestine in patients with colorectal cancer and inflammatory bowel disease[J].Gene,2022,820:146266.
[20] 中国抗癌协会肿瘤营养专业委员会,全国卫生产业企业管理协会医学营养产业分会,浙江省医学会肿瘤营养与治疗学分会.肿瘤患者食欲下降的营养诊疗专家共识[J].肿瘤代谢与营养电子杂志,2022,9(3):312-319.
[21] 章玲艳,吴会晨,汪飞,等.参苓白术散加减对结直肠癌患者化疗后骨髓抑制和免疫功能的影响[J].陕西中医,2023,44(8):1086-1089.
[22] 何华,高国翠.单味花椒治疗功能性消化不良脾胃虚寒证45例疗效观察[J].甘肃医药,2013,32(7):525-527.
[23] 武静,杨莎莎,杨毅,等.基于ERK1/2/核因子κB信号通路探讨大建中汤治疗肠易激综合征内脏痛[J].解剖学报,2022,53(3):281-287.
[24] HARUKI S,HIROYUKI S,MASAKAZU T,et al.Clinical efficacy of Daikenchuto(DKT:TJ-100)for gastrointestinal symptoms in patients with a history of colon and rectosigmoid cancer surgery:A randomized crossover study[J].Surg Today,2023,53(8):873-881.
[25] 尚磊.益气逐瘀汤在胃癌术后气虚血瘀证患者中的应用及对胃肠功能恢复影响[J].光明中医,2020,35(8):1130-1133.
[26] 徐斌.参黄汤对气滞血瘀型胃癌术后胃肠功能障碍患者胃肠激素及免疫功能的影响[J].中国误诊学杂志,2021,16(5):414-416.

相似文献/References:

[1]王文娟,邓 鑫,郭文斌,等.从“甘温建中”探讨糖尿病相关肌少症治疗思路[J].陕西中医,2020,(12):1790.[doi:DOI:10.3969/j.issn.1000-7369.2020.12.029]
[2]靳 楠,毛 月,刘 健,等.血液系统疾病常用药对探析[J].陕西中医,2022,(6):755.[doi:DOI:10.3969/j.issn.1000-7369.2022.06.019]
[3]胡圣涓,杨 婕,孙 韬.从《金匮要略》探讨骨髓抑制的中医辨治[J].陕西中医,2023,(7):925.[doi:DOI:10.3969/j.issn.1000-7369.2023.07.023]

备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助面上项目(81973640); 中国中医科学院科技创新工程项目(CI12022C002-04)
更新日期/Last Update: 2024-06-11