| 引用本文: |
王子涵, 王妍颖, 梁可欣, 魏红涛, 李杨帆.基于“天明则日月不明”理论探讨肺肠气机失调致结直肠腺瘤癌变机制及防治[J].湖南中医药大学学报,2026,46(1):101-106[点击复制] |
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| 基于“天明则日月不明”理论探讨肺肠气机失调致结直肠腺瘤癌变机制及防治 |
| 王子涵,王妍颖,梁可欣,魏红涛,李杨帆 |
| (首都医科大学附属北京友谊医院中医科, 北京 100050;首都医科大学附属北京中医医院消化中心, 北京 100010;首都医科大学附属北京友谊医院消化内科, 北京 100050) |
| 摘要: |
| 结直肠腺瘤（CRA）为结直肠癌（CRC）的关键癌前病变，其癌变机制与防治策略是中医药防治CRC的重要切入点。本文以《黄帝内经》“天明则日月不明”理论为基础，阐明“明”通“蒙”，喻示肺失清肃如天蒙阴翳，导致大肠传导失职、日月失辉，系统论述肺肠气机失调在CRA癌变中的核心作用。肺气壅滞致肠腑气滞为始动环节，进而湿瘀互结、浊毒内生，最终毒损肠络、癌毒形成，与“肺-肠轴”紊乱、肠道微生态失调、炎症介质累积及免疫抑制等现代病理过程密切相关。本文提出分期防治策略，始动期以宣肺通肠、化滞消癥为主，进展期强调清金化浊、剔络防变，质变期则注重固金伐毒、扶正消癥。基于“天明则日月不明”理论构建“肺肠同治”的防治体系，为阻断CRA癌变提供中医理论依据与临床实践路径，凸显“气机升降”在瘤癌转变防治中的整体调节特色。 |
| 关键词: 结直肠腺瘤 结直肠癌 天明则日月不明 肺肠轴 瘤癌转变 |
| DOI：10.3969/j.issn.1674-070X.2026.01.013 |
| 投稿时间：2025-07-27 |
| 基金项目:国家科技重大专项-四大慢病重大专项（2024ZD0520800，2024ZD0520802）；北京市属医院科研培育计划项目（PZ2022001）。 |
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| Mechanisms and prevention-treatment of colorectal adenoma carcinogenesis induced by lung-intestine qi dysregulation based on the theory of "obscured sun and moon from excessive celestial brightness" |
| WANG Zihan, WANG Yanying, LIANG Kexin, WEI Hongtao, LI Yangfan |
| (Department of Traditional Chinese Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;Department of Gastroenterology, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing 100010, China;Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China) |
| Abstract: |
| Colorectal adenoma (CRA) is a crucial precancerous lesion of colorectal cancer (CRC), and its carcinogenic mechanisms and prevention-treatment strategies represent important entry points in TCM for preventing and treating CRC. Based on the theory of "obscured sun and moon from excessive celestial brightness" from Huang Di Nei Jing (Huangdi's Classic of Medicine), this paper clarifies that "ming (brightness)" is synonymous with "meng (obscuration)", suggesting that when the lungs fail to maintain their purifying and descending function, it is akin to the sky being covered by clouds and shadows. This leads to malfunctioning of the large intestine's conduction and a loss of luster of the sun and moon (metaphorically representing large intestine's normal conductive functions). It systematically discusses the core role of lung-intestine qi movement dysregulation in the carcinogenesis of CRA. The initial trigger is lung qi stagnation, which causes intestinal qi stagnation. Subsequently, dampness and blood stasis intermingle, generating turbid toxins internally. Eventually, toxins damage the intestinal collaterals, leading to the formation of cancerous toxins. This process is closely related to modern pathological processes such as disruption of the "lung-intestine axis", intestinal dysbiosis, accumulation of inflammatory mediators, and immune suppression. This paper proposes a staged prevention-treatment strategy: In the initial stage, the focus is on dispersing the lungs and unblocking the intestines, as well as resolving stagnation and eliminating masses. During the progressive stage, emphasis is placed on clearing the lung and resolving turbidity, and moreover, removing collaterals obstruction to prevent pathological changes. In the qualitative change stage, the emphasis is on consolidating the lung, eliminating toxins, strengthening the body's resistance, and eliminating masses. By constructing a prevention-treatment system of "simultaneously treating the lungs and intestines" based on the theory of "obscured sun and moon from excessive celestial brightness", this paper provides a theoretical basis in TCM and a clinical practice pathway for blocking the carcinogenesis of CRA. It highlights the overall regulatory characteristic of "qi movement of ascent and descent" in the prevention and treatment of adenoma-carcinoma transition. |
| Key words: colorectal adenoma colorectal cancer obscured sun and moon from excessive celestial brightness lung-intestine axis adenoma-carcinoma transition |
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