基于中医“窍”理论的肿瘤证治思路探析

Analysis of tumor treatment ideas based on the“orifice”theory of traditional Chinese medicine

中医“窍”理论最早可追溯至《黄帝内经》,“窍”常指自然界或人体内的孔穴、孔道。本文基于中医“窍”理论的概念考证,试将其引入肿瘤证治研究,通过发散内外整体观、上下整体观、动静整体观等思维,认为孔窍是内外环境沟通的门户,机窍是气机升降出入的通道,神窍是形气协调驱动的本源,提出以“孔窍不通-机窍不利-神窍不用”为框架的肿瘤发生学体系。并据“窍”病变部位、肿瘤演进阶段、邪正虚实变化之不同,灵活采取宣孔窍、利机窍、调神窍的肿瘤治疗方法,以期为开展基于中医“窍”理论的恶性肿瘤辨证施治提供新的研究思路与视角。

The theory of“orifice”in traditional Chinese medicine(TCM)can be traced back to the Huangdi Neijing,which often refers to holes and channels in nature or the human body.Based on the textual research of the concept of“orifice”theory in TCM,this paper introduces it into the research of syndrome differentiation and treatment of tumor.Through the divergent thinking perspective of internal and external holistic view,upper and lower holistic view,and dynamic and static holistic view,it is considered that the“kong qiao”is the gateway for the communication between the internal and external environment,the“ji qiao”is the channel for the qi activity,and the“shen qiao”is the origin of the coordinated drive physique and qi.A tumorigenesis system based on the framework of“kong qiao blocked,ji qiao obstructed,shen qiao impeded”is proposed.Based on the different pathological locations of“orifice”,tumor progression stage,and the changes of pathogenic or healthy qi,deficiency,and excess,we should flexibly adopt the tumor treatment method of resuscitating or opening(xuan)kong qiao,promoting(li)ji qiao,and regulating(tiao)shen qiao,to provide new research ideas and perspectives for the syndrome differentiation and treatment of malignant tumors based on the theory of“orifice”of TCM.