基于“湿热蕴毒”探讨宫颈高危型人乳头瘤病毒感染“炎-癌转化”的中医药干预思路

Exploration of Traditional Chinese Medicine Interventions for Inflammationto-Tumor Transition in Cervical High-Risk Human Papillomavirus Infectionfrom the Perspective of Damp-Heat Accumulation Resulting into Toxin

“炎-癌转化”是宫颈由高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)感染发展至宫颈癌的重要机制之一。持续性宫颈HR-HPV感染作为宫颈癌的重要诱因,其引起的局部非可控性炎症微环境是宫颈癌发生的内在机制。“炎-癌转化”的宏观及微观病理过程均与中医“湿热蕴毒”的病机演变相契合,湿热聚结为“炎-癌转化”的驱动因素;湿热久蕴致脾虚肝郁为其病机演变特征;湿热久稽,肝脾失调,瘀滞蕴结胞门,终成“癌毒”。持续性宫颈HR-HPV感染所致的“炎-癌转化”进程主要责之于中医的湿、热、虚、毒病理因素。调控持续性宫颈HR-HPV感染炎性微环境为宫颈癌防治的重要途径。临证时以清热燥湿、健脾疏肝为核心治法,攻伐有道、内外同调,以截断“炎-癌转化”的进程。基于“湿热蕴毒”探讨持续性宫颈HR-HPV感染“炎-癌转化”进程,可为中医防治宫颈癌及中医药干预“炎-癌转化”提供思路。

Inflammation-to-tumor transition is one of the important mechanisms by which the cervical high-risk human papillomavirus(HR-HPV)infection develops into cervical cancer.Persistent cervical HR-HPV infection is an important cause of cervical cancer,and the focal uncontrolled inflammatory microenvironment caused by persistent cervical HR-HPV infection is the underlying mechanism of cervical cancer.The macroscopic and microscopic pathological process of inflammation-to-tumor transition is consistent with the pathogenesis evolution of damp-heat accumulation resulting into toxin in traditional Chinese medicine(TCM):the accumulation of damp-heat is the driving factor of inflammation-to-tumor transition,long-term retention of damp-heat leading to spleen deficiency and liver depression contributes to the characteristics of pathogenesis evolution,and long-term retention of damp-heat toxin causes the disorder of liver and spleen and then blood stasis accumulates in the cervical orifice,which eventually becomes cancer toxin.The process of inflammation-to-tumor transition caused by persistent cervical HR-HPV infection is due to the pathological factors of damp,heat,deficiency and toxin in TCM.Therefore,the regulation of inflammatory microenvironment caused by persistent cervical HR-HPV infection is the key approach to the prevention and treatment of cervical cancer.For the treatment of cervical cancer,methods of clearing heat and drying dampness,strengthening the spleen and soothing the liver are the key therapies.By intervention with the proper pathogen-eliminating methods and with simultaneous regulation of the interior and exterior,the process of inflammation-to-tumor transition can be interrupted.The exploration of inflammation-to-tumor transition caused by persistent cervical HR-HPV infection from the perspective of damp-heat accumulation resulting into toxin will provide thoughts for the prevention and treatment of cervical cancer with TCM and for Chinese medicine in intervening inflammation-to-tumor transition.