| 引用本文: |
胡馨雨, 谢虹亭, 李国栋, 刘泽豪, 薛鹏, 朱世杰.基于“脾-肠-肌”理论框架探讨肿瘤相关肌肉减少症的病机及辨治思路[J].湖南中医药大学学报,2026,46(5):1000-1005[点击复制] |
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| 基于“脾-肠-肌”理论框架探讨肿瘤相关肌肉减少症的病机及辨治思路 |
| 胡馨雨,谢虹亭,李国栋,刘泽豪,薛鹏,朱世杰 |
| (中国中医科学院望京医院肿瘤科, 北京 100102;北京中医药大学研究生院, 北京 100029) |
| 摘要: |
| 肿瘤相关肌肉减少症（CAS）是恶性肿瘤患者常见的并发症，以骨骼肌质量减少、肌力下降为主要特征，严重影响患者生活质量和生存预后。本文基于中医脏腑理论，结合现代微生态研究，构建“脾-肠-肌”理论框架，探讨其在维系肌肉荣养中的核心作用。CAS的核心病机可概括为脾虚肠损、精微不布、肌肉失养，据此确立健脾为本、升清降浊、分阶祛邪的治则，治疗上强调在健脾固本、升清降浊时，可根据病程中湿、痰、瘀等病理产物的演变，酌情分阶段祛邪。本研究旨在深化对CAS的中医病机认识，为中西医结合防治提供理论依据与临床思路。 |
| 关键词: 肿瘤相关肌肉减少症|“脾-肠-肌”理论|肠道菌群|健脾法|升清降浊 |
| DOI：10.3969/j.issn.1674-070X.2026.05.018 |
| 投稿时间：2025-10-29 |
| 基金项目:国家科技重大专项项目（2023ZD0502702）；国家自然科学基金面上项目（82575164）；中国中医科学院科技创新工程项目（CI2026A03811）。 |
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| Pathogenesis and pattern differentiation and treatment strategies for cancer-associated sarcopenia based on the "spleen-intestine-muscle" theoretical framework |
| HU Xinyu, XIE Hongting, LI Guodong, LIU Zehao, XUE Peng, ZHU Shijie |
| (Department of Oncology, Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing 100102, China;Graduate School, Beijing University of Chinese Medicine, Beijing 100029, China) |
| Abstract: |
| Cancer-associated sarcopenia (CAS) is a common complication in patients with malignant tumors, mainly characterized by reduced skeletal muscle mass and decreased muscle strength, and it seriously affects patients' quality of life and survival prognosis. Based on the Chinese Medicine zang-fu theory and integrating findings from modern microecological research, this paper constructs a "spleen-intestine-muscle" theoretical framework to explore its core role in maintaining muscle nourishment. The core pathogenesis of CAS can be summarized as spleen deficiency and intestinal impairment, failure of essential nutrients to be distributed, and consequent malnourishment of the muscles. Accordingly, the therapeutic principles are established as strengthening the spleen as the fundamental approach, ascending the clear and descending the turbid, and eliminating pathogenic factors in a stage-based manner. In treatment, emphasis is placed on strengthening the spleen and consolidating the root, while ascending the clear and descending the turbid; meanwhile, pathogenic factors such as dampness, phlegm, and blood stasis may be removed according to their stage-specific evolution during disease progression. This study aims to deepen the TCM understanding of CAS pathogenesis and to provide a theoretical basis and clinical perspective for its integrated prevention and treatment with Chinese and Western medicine. |
| Key words: cancer-associated sarcopenia|the "spleen-intestine-muscle" theory|gut microbiota|spleen-strengthening method|ascending the clear and descending the turbid |
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