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摘要
胃癌是起源于胃黏膜上皮细胞的恶性肿瘤。中医药治疗胃癌重视标本兼顾,临床需考量患者年龄、性别、刻下症状,溯源每个人气血阴阳盛衰,是对“人形”的判断。随四时六气之变化规律随证用药,以主要脏腑病变之行为治疗核心,并根据其余脏腑四行生克制化关系,兼调四脏。气滞寒凝为胃癌常见“人形”。防治胃癌重在“调人形、法四时、循五行”,包括:合人形,理气温阳并疏肝暖肾;法四时,用药作息遵四时之变;循五行,平调五脏以调平阴阳。
Abstract
Gastric cancer (GC) is a malignant tumor originating from the epithelial cells of the gastric mucosa. Traditional Chinese Medicine (TCM) emphasizes treating both symptoms and root causes in managing gastric cancer. Clinically, it is essential to consider the patient’s age, gender, and current symptoms, while tracing the individual’s condition of qi, blood, yin, and yang—essentially assessing their patient conditions, or renxing. Treatment should adapt to the seasonal and climatic changes according to the principles of the four seasons and six qi, using formulas tailored to the primary organ dysfunction as the core therapeutic focus, while also regulating the other organs based on the generating and controlling relationships of the five elements. Qi stagnation and cold coagulation are common patient conditions associated with GC. Prevention and treatment of GC hinge on “regulating patient conditions, following the seasons, and adhering to the five elements”, which includes: tailoring treatment based patient conditions by regulating qi, warming yang, and soothing the liver while nourishing the kidney; following the seasons by adjusting medication and daily routines according to seasonal changes; and adhering to the five elements by balancing the five zang-organs to restore harmony between yin and yang.
关键词
Key words
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吴俊汎,贾秋然,程诚,武佳鑫,戴斌彬,侯丽,李潇.
从“合人形法四时五行”论胃癌病机转变与防治[J].
现代中医临床, 2026, 33(4): 38-41 DOI:10.3969/j.issn.2095-6606.2026.04.007
| [1] |
中国抗癌协会胃癌专业委员会 . 2024版CACA胃癌整合诊治指南(精简版)[J]. 中国肿瘤临床, 2024, 51(13): 650-657.
|
| [2] |
王舒萍, 尹硕鑫, 方瑞超, 等 . 基于“癌毒—态靶”理论探讨胃癌的诊治思路[J]. 实用中医内科杂志, 2024, 38(6): 92-95.
|
| [3] |
吴俊汎, 董青, 姚梦丹, 等 . 从“合人形以法四时五行”理论探析恶性淋巴瘤的防治[J]. 中医学报, 2024, 39(7): 1417-1421.
|
| [4] |
赵鑫, 朱婷, 陈欣, 等 . 基于运气学说浅述脾与四时对应关系[J]. 亚太传统医药, 2024, 20(8): 225-228.
|
| [5] |
潘冬梅, 辛静, 李芬, 等 . 从中医阴阳学说理论探讨四时与顺时运动[J]. 武术研究, 2024, 9(6): 9-12.
|
| [6] |
吴雄志 . 吴述各家学说[M]. 沈阳: 辽宁科学技术出版社, 2020: 161.
|
| [7] |
孔维祎, 廖尖兵, 郝欧美 . 基于“中土五行”探讨钱乙从脾论治儿科疾病[J]. 中医研究, 2024, 37(10): 21-23.
|
| [8] |
PAGET S . The distribution of secondary growths in cancer of the breast. 1889[J]. Cancer Metastasis Rev, 1989, 8(2): 98-101.
|
| [9] |
王倩倩 . 胃癌患者中医证型与体质分类的相关性研究[D]. 太原: 山西医科大学, 2023.
|
| [10] |
杜炎远, 熊宏泰, 于惠博, 等 . 从“郁—虚—癌”立论探究胃癌的病因病机和治法[J]. 中医肿瘤学杂志, 2023, 5(4): 6-11.
|
| [11] |
李中梓 . 医宗必读[M]. 北京: 人民卫生出版社, 2023: 287.
|
| [12] |
朱震亨 . 丹溪心法[M]. 王英, 竹剑平, 江凌圳, 整理. 北京: 人民卫生出版社, 2017.
|
| [13] |
叶天士 . 景岳全书发挥[M]. 张丽娟, 点校. 北京: 中国中医药出版社, 2012: 156.
|
| [14] |
杨澜, 刘俊保 . 从脾虚痰湿、瘀、毒论治胃癌前病变[J]. 中医学报, 2024, 39(3): 525-528.
|
| [15] |
金梦雅, 宋亚楠, 朋小玲, 等 . 从痰湿论治胃癌[J]. 中医研究, 2024, 37(3): 9-11.
|
| [16] |
龚信 . 古今医鉴[M]. 北京: 中国医药科技出版社, 2014: 128.
|
| [17] |
张锡纯 . 重订医学衷中参西录[M]. 北京: 人民卫生出版社, 2006: 592.
|
| [18] |
裘怡婷, 卞泽人, 邹玺 . 胃癌脾虚瘀毒病机理论[J]. 光明中医, 2024, 39(20): 4105-4108.
|
| [19] |
曹瑜, 戴小军 . 参麦注射液治疗气阴两虚型胃癌癌因性疲乏的临床研究[J]. 深圳中西医结合杂志, 2023, 33(23): 8-12.
|
| [20] |
张莉萍, 王松浩, 朱洁, 等 . 养阴散结法辅助化疗治疗晚期胃癌阴虚证30例临床观察[J]. 湖南中医杂志, 2021, 37(9): 8-12.
|
| [21] |
张长征, 苗秀英, 刘振昌 . 附芪消肿方联合针刺治疗胃癌恶性腹水脾肾阳虚证56例[J]. 环球中医药, 2024, 17(11): 2364-2367.
|
| [22] |
匡子禹, 王佳曦, 曹璐畅, 等 . 基于“传舍”理论与“阳虚毒结”探讨胃癌术后复发转移的防治思路[J]. 中医杂志, 2023, 64(22): 2300-2304.
|
| [23] |
钱会南 . 同病异治的理论渊源与后世影响[J]. 中医研究, 2023, 36(9): 1-4.
|
| [24] |
苑清国 . 柴胡疏肝散加减联合西药治疗胃癌术后胆汁反流性胃炎患者的效果[J]. 中国民康医学, 2023, 35(3): 111-113.
|
| [25] |
宋晓彤 . 益气温阳解毒方调控肠道菌群—肿瘤微环境防治胃癌术后复发的机制研究[D]. 北京: 中国中医科学院, 2024.
|
| [26] |
赵洪彬, 吕丽媛, 刘铸, 等 . 基于“调平”理论探讨新加良附健脾益气合方在晚期胃癌维持治疗中的应用[J]. 现代中医临床, 2025, 32(6): 1-5.
|
| [27] |
安娣, 郭万林 . 王仁叟“木火同源”探讨[J]. 四川中医, 2020, 38(6): 42-44.
|
| [28] |
陈旭, 苏柏豪, 于会勇, 等 . 基于“四时之病,以其胜治之愈也”论治季节性过敏性鼻炎[J]. 吉林中医药, 2024, 44(11): 1274-1278.
|
| [29] |
刘梦婷, 杨毅 . 杨毅教授从“火烁肺金”论治支气管扩张症[J]. 内蒙古中医药, 2022, 41(1): 80-82.
|
| [30] |
张传龙, 高梦琦, 姜晓晨, 等 . 基于《黄帝内经》“四时五行”思辨恶性肿瘤扶正培本治则[J]. 中华中医药杂志, 2023, 38(3): 960-963.
|
| [31] |
韩奇成, 王宇立, 程东峰, 等 . 基于五运六气探讨胃癌患者先天运气禀赋特点及治疗策略[J]. 山东中医杂志, 2024, 43(7): 707-714.
|
| [32] |
郭喜平, 张耀圣, 卢冬冬, 等 . 王沛教授从本虚标实分阶段辨治胃癌经验[J]. 环球中医药, 2024, 17(4): 622-625.
|
| [33] |
齐宇镈, 张雅月, 张宇, 等 . 运用“调平与平调”治疗肿瘤治疗后继发再生障碍性贫血[J]. 现代中医临床, 2026, 33(1): 75-80.
|
基金资助
中央高校基本科研业务费项目(2024-JYB-JBZD-012)
首都卫生发展科研专项项目(首发2024-2-4194)
国家自然科学基金项目(81573959)