结直肠癌前病变中医病机探讨

在癌毒病机理论的指导下，提出结直肠癌前病变的共性病机为湿热毒蕴，脾气亏虚。湿、热之邪在脾虚的基础上产生并相互胶结于肠腑，日久内生癌毒。脾气亏虚是结直肠癌前病变发生的根本病机，湿热蕴结是其发展条件，癌毒内生是癌变的关键所在。结合内镜下病理分级，根据癌毒内生与否可将结直肠癌前病变的演变过程分为无癌毒期及癌毒期。癌毒致病的过程即结直肠癌前病变发展成为结直肠癌的过程。因此，根据结直肠癌前病变处于无癌毒期或癌毒期的病机采取相应的治法，清除癌毒产生之源或已生之癌毒，可达到抑制其癌变，逆转癌瘤形成的目的。 

Discuss on the Pathogenesis of Colorectal Precancerous from the Perspective of Traditional Chinese Medicine

Under the guidance of the theory of cancerous toxin pathogenesis, it is proposed that the common pathogenesis of colorectal precancerous lesion is damp-heat toxin accumulation and deficiency of spleen qi. Damp-heat toxin is induced by deficiency of spleen, retained in zang-fu organs and then transformed into cancerous toxin. Deficiency of spleen is the fundamental pathogenesis of colorectal pre-cancer lesion while damp-heat toxin accumulation is the development condition. The endogenous cancerous toxin is the key to cancerization. Combined with endoscopic pathological grading, the evolution of pre-colorectal lesion can be divided into cancerous toxin-free period and cancerous toxin period according to whether there is endogenous cancerous toxin or not. The process of disease onset induced by cancerous toxin is the process of colorectal precancerous lesion transforming into colorectal cancer. Therefore, according to the pathogenesis of colorectal precancerous lesion either in cancerous toxin-free period and cancerous toxin period, corresponding treatment methods should be applied to remove the source of cancerous toxin or endogenous cancerous toxin, which can achieve the purpose of inhibiting cancerization and reversing the formation of cancer.