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胡凯文基于"升清降浊"理论治疗胰腺癌经验OA

Hu Kaiwen's Experience in Treating Pancreatic Cancer Based on the Theory of"Ascending Lucidity and Descending Turbidity"

中文摘要英文摘要

胰腺癌是消化系统恶性肿瘤,晚期主要临床表现为黄疸、腹水、消瘦等,治愈率较低,对人类健康造成了较大危害.中医药在胰腺癌的治疗中展现出有效性、安全性.胡凯文教授以"升清降浊"理论为核心,提出了胰腺癌"清浊失调"的中医病机,并围绕藏象学"胰脾关系",从二者的形态、功能角度分析胰腺癌的病位、病势及虚实特点,明确了胰腺癌"清浊滞涩中焦,清以浊为基,浊以清为使,久则化生癌毒"的致病过程,并参考现代医学研究成果,将"重建清浊循环"与"肿瘤微环境调控"创新性结合,最终提出"急性期以邪盛为主,重在祛邪,达邪开滞通中焦""慢性期以正虚为主,重在补中,扶正理脾助升发""隐匿期邪隐正未复,以整复清浊,重建清浊循环为核心"的中医药分期辨治策略,丰富了"升清降浊"理论的应用范围,为胰腺癌的临床治疗方案提供了新视角,也为传统中医药与现代医学的有机结合铺设了新途径.

Pancreatic cancer is a malignant tumor of the digestive system.Its advanced stage is mainly characterized by clinical manifestations such as jaundice,ascites,and emaciation,with a low cure rate,posing significant harm to human health.Traditional Chinese medicine(TCM)has demonstrated effectiveness and safety in the treatment of pancreatic cancer.Professor Hu Kaiwen,based on the theory of"ascending lucidity and descending turbidity",proposed the TCM pathogenesis of"imbalance of the clear and turbid"in pancreatic cancer.By focusing on the"relationship between the pancreas and spleen"in visceral manifestation theory,he analyzed the disease location,progression,and characteristics of deficiency and excess in pancreatic cancer from the perspectives of morphology and function.This clarified the pathogenic process of pancreatic cancer:"stagnation of the clear and turbid in the middle energizer,with the clear relying on the turbid as its foundation and the turbid depending on the clear as its guide,eventually transforming into cancer toxin over time".Drawing on modern medical research,he innovatively combined"rebuilding the circulation of the clear and turbid"with"tumor microenvironment regulation".Ultimately,he proposed a staged TCM diagnosis and treatment strategy:"In the acute phase,pathogenic excess predominates,focusing on expelling pathogens to unblock stagnation and clear the middle energizer";"In the chronic phase,deficiency of healthy Qi predominates,focusing on fortifying the middle energizer,supporting healthy Qi,regulating the spleen,and promoting upward movement";"In the latent phase,pathogens are hidden while healthy Qi is not yet restored,focusing on restoring the clear and turbid and rebuilding their circulation".This approach enriches the application scope of the theory of"ascending lucidity and descending turbidity",provides new perspectives for clinical treatment strategies for pancreatic cancer,and paves a new path for the organic integration of traditional Chinese medicine and modern medicine.

张墨涵;胡凯文;孙静宜;王潇凡;王婧筱;于欣

北京中医药大学,北京 100029北京中医药大学东方医院,北京 100078北京中医药大学东方医院,北京 100078北京中医药大学,北京 100029北京中医药大学,北京 100029北京中医药大学,北京 100029||北京市朝阳区中医医院,北京 100020

医药卫生

胰腺癌升清降浊分期辨治临床经验

Pancreatic cancerAscending lucidity and descending turbidityStaged diagnosis and treatmentClinical experience

《中国中医基础医学杂志》 2026 (2)

385-389,5

第六批北京市级中医药专家学术经验继承工作项目2024年度内蒙古自治区蒙医药学会科学技术研究项目(MXK065)天津市2025年度中医中西医结合科研课题(2025195)中央财政支持中医药事业传承与发展示范试点项目(11010524T000002489480)北京市科技新星项目(2022041)国家自然科学基金青年项目(82104651)中央高水平中医医院临床科研业务费资助项目(2025XZYJ08)

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