基于“伏毒致病”学说探讨预防结直肠腺瘤复发的证治思路

Prevention of Colorectal Adenoma Recurrence Based on Theory of Latent-toxin Pathogenesis

降低结直肠腺瘤(colorectal adenoma,CRA)复发率为临床治疗的难点,西药预防存在副作用大或疗效不确定等问题。广东省名老中医罗云坚教授认为脾虚湿瘀是CRA发生及复发的关键,并提出了CRA的“伏毒致病”学说。结直肠腺瘤发生及复发的宿根在于伏毒,湿、瘀、热等毒邪损伤肠络,肠道无以运化津液,湿瘀热胶着为毒,形成循环,互为因果,最终发为腺瘤。临床上以扶正祛毒为治疗根本,自拟调肠消瘤方以健脾化湿、活血化瘀,辨证论治,预防腺瘤复发疗效显著。

The difficulty of treatment of colorectal adenoma in the clinic is to lower the recurrence rate.Western medicine in the treatment of colorectal adenoma has the disadvantages of having obvious side effects and uncertain therapeutic effects.Professor LUO Yun-Jian,one of the famous Chinese medicine physicians of Guangdong Province,suggested that spleen deficiency with dampness and blood stasis is the key for the occurrence and recurrence of colorectal adenoma,and puts forward the theory of latent-toxin pathogenesis for colorectal adenoma.The occurrence and recurrence of colorectal adenoma are due to the root cause of latent toxins,the latent toxins which developed from the toxic pathogens of dampness,blood stasis and heat injure the intestinal collaterals and result into the failure of the intestine in transporting the body fluid,and then the interaction of the latent toxins with the toxin pathogens of dampness,blood stasis and heat finally causes the occurrence of colorectal adenoma.The therapeutic principles for colorectal adenoma are to support healthy qi to eliminate toxins,and the selfprescribed prescriptions of Tiaochang Xiaoliu Recipe has the actions of invigorating spleen and eliminating dampness,and promoting blood circulation to remove blood stasis,which can achieve satisfactory efficacy on preventing the recurrence of colorectal adenoma in the clinic by the modified usage based on syndrome differentiation.