论中医体质与弥漫大B细胞淋巴瘤发病及疗效预后

Discussion on Correlation Between Chinese Medicine Constitutions and Attack and Prognosis of Diffuse Large B-cell Lymphoma

不同人群在相同环境下有的发生肿瘤,有的不发生,原因就是不同个体体质差异对环境的反应性不同,个体体质的特殊性决定机体对某种致病因子或疾病的易感性。对于弥漫大B细胞淋巴瘤(diffuse large B-celllymphoma,DLBCL)而言,同是感染EB病毒或逆转录病毒等外邪,免疫功能低下或缺陷的体质特征最终决定机体更易罹患该病。中医体质不仅决定人体感邪之后发病有否,而且决定人体疾病的证候本质,并最终影响疗效。相同病理类型DLBCL疗效及预后的异质性应源于体质的差异性。虽然现代医学强调的分层治疗在一定程度上能杜绝一个方案"包治"所有病人的弊端,但仍然不能实现"因人因证之辨"。故而,临床难免出现,用同一方案规范化治疗相同病理类型的病人,疗效及预后却有明显的差异。所以,治疗此病当区别不同体质而行之,即"因人施治"。探讨具体体质条件与DLBCL病理类型之间的关系,探明不同体质DLBCL的生物学特征,辨析体质与DLBCL发病及疗效预后的关系,将有助于对DLBCL进行进一步的分层,最终实现"治病求本""因人施治"。

Susceptibility to some kinds of pathogenic factors or diseases is decided by specificities of individual constitutions, and diverse individual constitutions have different responsivities to the environment. So in the same environment, some people suffer tumor attack, while some don＇t. As diffuse large B-cell lymphoma （ DLBCL ） is accounted, constitution of immunity hypofimction or deficit is more accessible to DLBCL after being infected by EB virus or retrovirus. Despite of attack and syndrome essence of diseases, curative effect is contributed to Chinese medicine constitutions. Curative effect and prognosis heterogeneity of DLBCL with the same pathological pattern should root in constitntion dissimiIitude. Although disadvantages caused by applying one therapeutic schedule on all patients have been declined to some extent, differentiation on different individuals and syndromes is still not achieved. Then, curative effect and prognosis of patients with the same pathological pattern are entirely different even treated by the same standard therapeutic schedule. So, we think that therapeutic schedule on DLBCL may be laid down according to diverse constitutions. That is treatment according to various individuals. It wonld be conducive to further flatted treatment on DLBCL that can ascertain correlation between specific Chinese medicine constitutions with pathological pattern, curative effect amt prognosis, and verify biological characteristics of DLBCL with diverse Chinese medicine constitutions. Thus, the theory of searching for the primary c, ause of disease in treatment and treatment accordin~ to various individuals would be performed.