基于“邪伏络脉”探讨运用虫类药清除膀胱癌术后余毒的策略

Eliminating postoperative residual toxins in bladder cancer with insect drugs: a strategy grounded in the “latent pathogens in collaterals” theory

摘要

叶天士于《临证指南医案》提出“久病入络,当以虫蚁攻逐”,对膀胱癌术后残存余毒的清除具有重要指导意义。依据络病理论,金刃所伤、久病致虚均可导致毒邪入络、络脉瘀损,这正是膀胱癌患者术后因邪伏于络而发生复发的病理基础。本文基于“邪伏络脉”的理论,结合现代医学研究进展,提出虫类药可通过调节化痰散结、破瘀通络、搜毒剔络、温肾行气等,改善肿瘤微环境,抑制膀胱肿瘤生长,并对虫类药的用药规律进行系统分析,总结其临床应用特点,期望为中医防治膀胱癌术后复发提供新的视角和思路。

Abstract

Based on the theory of “Pathogens Lurking in the Collaterals” proposed by Ye Tianshi in “Case Reports for Clinical Practice”, the principle of “using insect-form medicines to attack and expel the latent pathogen” provides significant guidance for eliminating residual toxins after bladder cancer surgery. According to collateral disease theory, both surgical trauma and chronic illness leading to deficiency can result in pathogenic toxins invading collaterals with stasis and impairment. This pathological mechanism underlies post-operative recurrence in bladder cancer patients due to pathogens lurking within the collaterals. Based upon the “Pathogens Lurking in the Collaterals” theory and integrating modern medical research, this paper proposes that insect-form medicines can inhibit bladder tumor growth and improve the tumor microenvironment through multi-target actions. These include resolving phlegm and dissipating masses, breaking stasis and unblocking collaterals, searching out toxins and dredging collaterals, and warming the kidney to promote qi flow. Furthermore, we systematically elucidate the clinical deployment patterns of insect-based agents and summarize their characteristic therapeutic applications. It is anticipated that these insights will provide novel perspectives for Traditional Chinese Medicine (TCM) in the prophylaxis and management of post-resection bladder cancer recurrence.

关键词

邪伏络脉 / 虫类药 / 肿瘤微环境 / 膀胱癌 / 术后复发

Key words

latent pathogens in collaterals / insect drugs / tumor mircroenvironment / bladder cancer / postoperative recurrence