大柴胡汤在消化系统肿瘤中的研究进展

Da Chaihutang Treats Digestive System Tumors:A Review

大柴胡汤出自《伤寒论》,功在和解少阳,内泻热结,张仲景先师专为少阳阳明合病所设,近年来广泛用于各种消化系统疾病,尤其是消化系统恶性肿瘤的治疗中,收效良好。该文检索整理近20年文献,从基础方证探析、临床研究、机制研究3方面总结大柴胡汤在消化系统肿瘤中的应用,发现该方基础方证具有少阳阳明蕴含消化系统之象、表里双解以成畅内达外之势、以通立法顺应六腑和降之性等特点。在临床研究中,一可直接治疗肝癌、胰腺癌、肠癌、胃癌、胆囊癌等消化系统肿瘤;二可缓解癌性发热、恶性梗阻性黄疸、大便秘结等消化系统肿瘤常见并发症;三可减轻消化系统肿瘤西医治疗的不良反应如栓塞后综合征、化疗不良反应、术后不全梗阻等,单用即可收效,在减轻临床症状、改善晚期患者预后、延长生存时间上,疗效确切,且安全无毒,适合肿瘤患者长期服用。在机制研究中,大柴胡汤具有促进肿瘤细胞凋亡、抑制肿瘤细胞增殖,抗炎、减轻炎症损伤,改善肝功能等机制,作用明确,机制清晰,证实了大柴胡汤的抗肿瘤作用。通过以上3部分,全面阐述了大柴胡汤在消化系统肿瘤中的研究现状,并针对目前的研究提出了不足与改进,以期为该方在消化系统肿瘤中的应用、肿瘤中西医治疗模式的构建、肿瘤药物的研发提供参考和借鉴。

Da Chaihutang from the Treatise on Febrile Disease(Shanghanlun)has the function of harmonizing lesser Yang and discharging internal heat.It is formulated by ZHANG Zhongjing for the concurrent diseases of lesser Yang and Yang brightness and has been widely used in the treatment of digestive system diseases,especially malignant tumors.By review of the articles published in the last 20 years,this paper summarizes the application of Da Chaihutang in treating digestive system tumors from syndrome analysis,clinical research,and mechanism research.Da Chaihutang can treat the syndrome involving lesser Yang and Yang brightness in the digestive system,release interior and exterior to expel pathogen,and remove obstruction by conforming to the descending nature of the six fu-organs.In clinical practice,Da Chaihutang can directly treat digestive system malignant tumors such as liver cancer,pancreatic cancer,intestinal cancer,gastric cancer,and gallbladder cancer.In addition,it can relieve common complications of digestive system malignant tumors,such as cancerous fever,malignant obstructive jaundice,and constipation.Moreover,it can alleviate the adverse reactions caused by Western medical treatment,such as post-embolization syndrome,side effects of chemotherapy,and incomplete postoperative obstruction.Da Chaihutang is effective when used alone as it can relieve clinical symptoms,improve prognosis,and prolong survival of advanced patients and is safe and nontoxic,suitable for long-term use by tumor patients.Regarding the mechanism,Da Chaihutang can promote the apoptosis and inhibit the proliferation of tumor cells,reduce inflammation and inflammatory injury,and improve the liver function.The clear effect and mechanism confirms the anti-tumor effect of Da Chaihutang.This paper comprehensively describes the current research status of Da Chaihutang in the treatment of digestive system tumors and puts forward the deficiencies and improvement measures for the current research,aiming to provide reference for the application of this formula in treating digestive system tumors,the establishment of Chinese and Western medicine treatment schemes of tumors,and the research and development of anti-tumor drugs.