基于“肝脾同病”探析结肠癌肝转移的中医治疗

Discussion on Treatment of Liver Metastasis of Colon Cancer with Traditional Chinese Medicine Based on the Theory of Liver and the Spleen Comorbidity

结肠癌肝转移是“肝脾同病”这一病机的典型体现。从肠肝循环、肠道微生态、结肠癌肝转移前微环境等角度探讨结肠癌肝转移“肝脾同病”,进一步指出“肝脾同调”治则应贯穿结肠癌肝转移防治全程,总以健脾理脾为主、疏肝柔肝为辅,兼用化痰通络散瘀、解毒消癥之法,可选用逍遥散、柴芍六君子汤等方。“肝脾同病”理论指导结肠癌肝转移治疗的核心在于调理肝脾,或通过恢复肠道菌群稳态、调控免疫失衡及慢性炎症从而延缓疾病的发展。

Liver metastasis of colon cancer is a typical representative of the pathogenesis of liver and the spleen comorbidity.This paper expounded the pathogenesis of liver and the spleen comorbidity in liver metastasis of colon cancer from the perspectives of enterohepatic circulation,intestinal microecology and pre-metastatic mircroenviro⁃ment.It is further pointed out that the method of“simultaneous regulation of liver and the spleen”should run through the whole process of prevention and treatment of liver metastasis of colon cancer,mainly by fortifying and rectifying the spleen supplemented with soothing and softening the liver;the methods of dissolving phlegm,unblocking collaterals,dissipating stasis,and resolving toxins and eliminating concretions can be combined.Xiaoyao Powder(逍遥散)and Chaishao Liujunzi Decoction(柴芍六君子汤)can be used.The core of the theory“liver and the spleen comorbidi⁃ty”in guiding the treatment of liver metastasis of colon cancer is to regulate both the liver and spleen,and its mecha⁃nism may be delaying the development of the disease by restoring intestinal flora homeostasis,regulating immune im⁃balance and chronic inflammation.