基于肠道微生态理论探讨清热祛湿法对结直肠癌的防治
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摘要
近年来,我国结直肠癌的发病率逐年上升,正在严重威胁我国国民生命健康。结直肠癌的发生发展与肠道微生态的失衡具有相关性。根据近年来针对结直肠癌的临床证型探讨和分析,发现湿热证是最常见的致病因素及临床证型之一。微生态失衡可导致脾胃受损从而导致湿热证候,而湿热停滞也可能导致肠道菌群的失衡,两者可能存在互为因果的关系。临床上应合理运用清热祛湿法,调节肠道微生态失衡,根据患者体质及病情进行个性化的中西医诊疗及防治。本文基于中医整体观念原则及肠道菌群理论,综合肠道微生态与结直肠癌湿热证的研究,提出以清热祛湿法对结直肠癌的防治思路,为临床提供参考。
The incidence of colorectal cancer is increasing year by year,which threatening Chinese people's health and life gravely.The imbalance of intestinal microecology plays a role in the pathogenesis and progression of colorectal cancer.According to the literatures on discussion and analysis of clinical syndromes about colorectal cancer in the recent year,it is found that damp-heat syndrome is one of the most common pathogenic factors and clinical syndromes.The dysbiosis of intestinal flora can lead to the syndrome of dampness-heat due to spleen deficiency.On the other hand,the stagnation of damp-heat could result in the imbalance of intestinal flora,too.They may influence each other.The methods of removing heat and dispersing dampness for regulating the dysbiosis of intestinal flora should be used flexibly for clinic.Meanwhile,the individualized diagnosing,treating and disease prevention integrated traditional Chinese and western medicine should be carrying out basing on the patient's concrete condition.Depended on the holistic principle of TCM and the theory of intestinal micro-ecology,this paper has integrated the researches on intestinal micro-ecology and the damp-heat syndrome of colorectal cancer,and has proposed the prevention and treatment of colorectal cancer by removing heat and dispersing dampness for clinical reference.
The incidence of colorectal cancer is increasing year by year,which threatening Chinese people's health and life gravely.The imbalance of intestinal microecology plays a role in the pathogenesis and progression of colorectal cancer.According to the literatures on discussion and analysis of clinical syndromes about colorectal cancer in the recent year,it is found that damp-heat syndrome is one of the most common pathogenic factors and clinical syndromes.The dysbiosis of intestinal flora can lead to the syndrome of dampness-heat due to spleen deficiency.On the other hand,the stagnation of damp-heat could result in the imbalance of intestinal flora,too.They may influence each other.The methods of removing heat and dispersing dampness for regulating the dysbiosis of intestinal flora should be used flexibly for clinic.Meanwhile,the individualized diagnosing,treating and disease prevention integrated traditional Chinese and western medicine should be carrying out basing on the patient's concrete condition.Depended on the holistic principle of TCM and the theory of intestinal micro-ecology,this paper has integrated the researches on intestinal micro-ecology and the damp-heat syndrome of colorectal cancer,and has proposed the prevention and treatment of colorectal cancer by removing heat and dispersing dampness for clinical reference.
引文
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[31]江月斐,劳绍贤,邝枣园,等.清热化湿复方对腹泻型肠易激综合征脾胃湿热证肠道微生态影响的初步研究[J].福建中医学院学报,2008,(04):1~4
[2]Manzat-Saplacan RM,Mircea PA,Balacescu L,et al.Can we change our microbiome to prevent colorectal cancer development?[J].Acta Oncol,2015,54(8):1085~1095
[3]Frick JS,Autenrieth IB.The gut microflora and its variety of roles in health and disease[J].Curr Top Microbiol Immunol,2013,358:273~289
[4]Haag LM,Siegmund B.Intestinal Microbiota and the Innate Immune System-A Crosstalk in Crohn's Disease Pathogenesis[J].Front Immunol,2015,6:489
[5]Liang J,Sha SM,Wu KC.Role of the intestinal microbiota and fecal transplantation in inflammatory bowel diseases[J].J Dig Dis,2014,15(12):641~646
[6]Kawano A,Ishikawa H,Nakamura T,et al.Evaluation of epidemiological studies of intestinal bacteria that affected occurrence of colorectal cancer:studies of prevention of colorectal tumors by dairy products and lactic acid bacteria[J].Nihon Eiseigaku Zasshi,2010,65(3):422~446
[7]Li Y,Zhang X,Wang L,et al.Distribution and gene mutation of enteric flora carrying beta-glucuronidase among patients with colorectal cancer[J].Int J Clin Exp Med,2015,8(4):5310~5316
[8]Han S,Gao J,Zhou Q,et al.Role of intestinal flora in colorectal cancer from the metabolite perspective:a systematic review[J].Cancer Manag Res,2018,10:199~206
[9]詹宏杰,梁寒.肠道菌群与结直肠癌关系研究进展[J].中国肿瘤临床,2015,42(13):675~679
[10]魏莉平,刘诚明.结直肠癌与肠道菌群关系的研究进展[J].海南医学,2015,26(9):1328~1330
[11]Scanlan PD,Shanahan F,Clune Y,et al.Culture-independent analysis of the gut microbiota in colorectal cancer and polyposis.Environ Microbiol,2008,10(3):789~798
[12]Qin J,Li R,Raes J,et al.A human gut microbial gene catalogue established by metagenomic sequencing[J].Nature,2010,464(7285):59~65
[13]Marchesi JR,Dutilh BE,Hall N,et al.Towards the human colorectal cancer microbiome[J].PLoS One,2011,6(5):e20447
[14]Culpepper BST,Mai V.Evidence for Contributions of Gut Microbiota to Colorectal Carcinogenesis[J].Current Nutrition Reports,2013,2(1):10~18
[15]司富春,岳静宇.近30年大肠癌中医证型和用药规律分析[J].中华中医药杂志,2012,27(07):1929~1931
[16]王国娟,余文燕.大肠癌中医证型规律研究[J].中华中医药杂志,2016,31(03):837~840
[17]侯风刚,岑怡,贯剑,等.肠癌中医症状证候临床调查分析[J].辽宁中医药大学学报,2010,12(01):33~35
[18]邵梅,舒琦瑾.大肠癌中医证型构成及分布规律初探[J].中华中医药学刊,2012,30(02):436~438
[19]赵宗辉.结直肠癌患者手术前后中医辨证分型及演变规律研究[D].广州中医药大学,2014
[20]谭玮璐.复发性大肠息肉的中医证候分布规律研究及中医体质调查[D].广州中医药大学,2010
[21]王婷,郑锋玲,骆欢欢.岭南温病湿热证小鼠模型的建立及肠道菌群的研究分析[J].中华中医药学刊,2017,35(06):1361~1365
[22]江月斐,劳绍贤,邝枣园,等.腹泻型肠易激综合征脾胃湿热证肠道菌群的变化[J].中国中西医结合杂志,2006(03):218~220
[23]陈晓刚.小儿再发性腹痛的脾胃湿热证与肠道微生态关系的研究[D].广州中医药大学,2007
[24]罗海燕,宋姗姗,黄暨生,等.黄芩苷对小鼠肠道菌群影响的量-时规律观察[J].中国医药指南,2010,32(8):42~43+49
[25]冯澜,李绍民,代立娟,等.马齿苋多糖对溃疡性结肠炎小鼠肠黏膜细胞因子及肠道菌群的影响[J].中国微生态学杂志,2015,27(02):139~142
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[28]康超颖,张旭,赵梅,等.小檗碱对大鼠肠道菌群结构的体外影响[J].中国微生态学杂志,2013,25(10):1117~1122
[29]曾艺鹏,冯新格,谷成英,等.葛根芩连汤治疗对2型糖尿病湿热证肠道菌群影响[J].河北医学,2016,22(10):1731~1734
[30]周正华.口服中药联合青赤散灌肠对大肠湿热型溃疡性结肠炎患者肠道菌群影响[A].中国中西医结合学会消化系统疾病专业委员会.第二十九届全国中西医结合消化系统疾病学术会议论文集[C].中国中西医结合学会消化系统疾病专业委员会,2017:1
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