基于“营卫理论”浅谈昼夜节律与恶性肿瘤之间的关系

Discussion on the relationship between circadian rhythm and malignant tumors based on the theory of nutrient qi and defensive qi

基于以“气一元论”与“阴阳两分”为哲学基础的营卫理论,阐述昼夜节律与恶性肿瘤之间的复杂关系,认为昼夜节律紊乱与恶性肿瘤之间的关联之一或可用“营卫运行失常”的观点加以解释。昼夜节律与恶性肿瘤之间复杂串扰可用“阴阳相逆,营卫失和”以及“邪盛气壅,荣卫不行”的基本病机进行简要概括,进而发现在治疗中中医、西医有“分时而治”的特点,具体特点在中医治疗中可概括为引阳入阴、调畅气机、分时治疗三个方面;而在西医治疗中,临床也逐渐关注到抗肿瘤药物的疗效、毒性因给药时间不同而产生变化,从而发现靶向药物联合时辰化疗具有的挖掘潜力以及靶向药物对辅助改善机体昼夜节律体现出的积极作用。通过对昼夜节律紊乱与恶性肿瘤之间复杂关系的初步归纳,以期为恶性肿瘤的中医治疗提供更多证据支撑。

Based on the traditional Chinese philosophy of"qi monism"and"yin and yang",this paper applies the theory of nutrient qi and defensive qi to elaborate on the complex relationship between circadian rhythm and malignant tumors,holding that one of the associations between them can be explained by the viewpoint of"abnormal circulation of nutrient qi and defensive qi".So the complex interference between them may be briefly summarized by the basic pathogenesis of"inversion of yin and yang,disharmony between nutrient qi and defensive qi"as well as"qi congestion due to excessive pathogens,circulation failure of nutrient qi and defensive qi".And based on the above discussions,it is found that both Chinese and western medicine are characterized by"chronotherapy".To be specific,the treatment of traditional Chinese medicine is characterized by the ideas of yin-yang balance,activating qi circulation and treating according to time,while in western medicine,attention has gradually been paid to the changes in the eficacy and toxicity of antitumor drugs depending on their different administration time,which has led to the discovery of the potentials of targeted drugs as well as the chronotherapy and the positive role of targeted drugs in improving the circadian rhythm of the body.In this paper,the complex relationship between CRD and malignant tumors is preliminarily summarized in order to provide more evidence support for the TCM treatment of malignant tumors.