探讨中医“既病防变”理论与自噬在宫颈癌前病变防治中的微观联系

以既病防变的宏观治病思路深入剖析,探讨其与自噬可能存在微观联系。认为自噬作为一种自我保护性的细胞死亡,对维持细胞及机体内环境稳态具有重要作用。近年来发现自噬水平的高低影响着宫颈癌前病变的发生发展,具有双向调节作用。中医既病防变理论包含了早期治疗及防止传变两层含义,抓住宫颈癌前病变这一黄金期进行调控的思路,与中医"既病防变"理论不谋而合,从中医微观辨证角度探讨,自噬机制与人之"正气"相类,自噬维持的稳态即"阴平阳秘"状态,既病防变理论原则下需要早期扶正制邪及平衡阴阳,防止疾病传变,当下中医药对细胞自噬的调节作用已有一定的实验论证,但证据不够充分,其中的调控机制仍亟待研究。

To Explore the Microscopic Relationship Between the Theory of"Preventing Disease from Exacerbating"in Traditional Chinese Medicine and Autophagy in the Prevention and Treatment of Cervical Intraepithelial Neoplasia

According to the macro treatment idea of preventing disease from exacerbating,the possible microscopic relationship between it and autophagy was explored.It is considered that autophagy,as a kind of self-protective cell death,plays an important role in maintaining the homeostasis of cells and internal environment of the body.In recent years,it has been found that the level of autophagy affects the occurrence development of cervical intraepithelial neoplasia and has the function of dual-direction regulation.The theory of preventing disease from exacerbating in traditional Chinese medicine contains two meanings:early treatment and prevention of exacerbating,and holds the idea of regulation in the prime period of cervical intraepithelial neoplasia,which coincides with the theory of"preventing disease from exacerbating"in traditional Chinese medicine.From the perspective of microscopic syndrome differentiation of traditional Chinese medicine,the mechanism of autophagy is similar to the"vital Qi"of human beings,and the homeostasis maintained by autophagy is the state of"relative equilibrium of Yin-Yang".Under the principle of preventing disease from exacerbating,it is necessary to strengthen body resistance to dispel pathogenic factors in early stage and balance yin and yang to prevent disease transmission.At present,there has been some experimental demonstration on the regulatory effect of traditional Chinese medicine on cell autophagy,but the evidence is not sufficient,and the regulation mechanism still needs to be studied.