基于癌毒病机理论的胃肠恶性肿瘤中医证候调查研究*

作者：郭天灏1,2,3，朱文坚2，李 柳2，吴晓宇1，程海波1,2

单位：1.南京中医药大学附属医院（江苏省中医院），江苏 南京 210029； 2.南京中医药大学第一临床医学院，江苏省中医药防治肿瘤协同创新中心，江苏 南京 210023； 3.江苏开放大学健康养生研究所，江苏 南京 210036

引用：引用：郭天灏，朱文坚，李柳，吴晓宇，程海波.基于癌毒病机理论的胃肠恶性肿瘤中医证候调查研究[J].中医药导报,2026,32(2):101-108.

DOI：10.13862/j.cn43-1446/r.2026.02.016

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摘要：目的：探讨胃肠恶性肿瘤的中医证候分布特点及规律。方法：采用横断面调查方法，对186例胃癌患者及300例结直肠癌患者进行中医证候的信息采集和中医辨证分型研究。结果：胃癌患者中医证候以脾虚瘀毒证最为多见。胃癌患者脾虚瘀毒证候与性别、病理分期、血常规（红细胞计数、血红蛋白、白细胞计数、中性粒细胞绝对值、血小板）、粪便常规、生化检验指标（天冬氨酸氨基转移酶、丙氨酸氨基转移酶、血肌酐、血尿素氮）、癌胚抗原（CEA）、糖类抗原19-9（CA19-9）、甲胎蛋白（AFP）、糖类抗原72-4（CA72-4）、糖类抗原125（CA125）、腹痛情况、腹胀情况、大便性质、嗳气情况、泛酸情况、恶心呕吐情况尚不存在明显相关性。结直肠癌患者中医证候以脾虚瘀毒证最为多见。结直肠癌患者脾虚瘀毒证候与CEA、CA19-9、大便性质、腹部肿块、肠鸣情况存在一定相关性；与病理分期、血常规（红细胞计数、血红蛋白、白细胞计数、中性粒细胞绝对值、血小板）、粪便常规、生化检验指标（天冬氨酸氨基转移酶、丙氨酸氨基转移酶、血肌酐、血尿素氮）、AFP、CA72-4、CA125、腹痛情况、腹胀情况、矢气情况尚不存在明显相关性。结论：脾虚瘀毒证是胃肠恶性肿瘤最主要的中医证候，与CEA、CA19-9、大便性质、腹部肿块、肠鸣情况存在一定相关性。

关键词：胃肠恶性肿瘤；胃癌；结直肠癌：中医证候；癌毒病机理论

Abstract：

Objective: To investigate the distribution characteristics and patterns of Traditional Chinese Medicine (TCM) syndromes in gastrointestinal malignancies. Methods: A cross-sectional survey was conducted to collect information on TCM syndromes and perform syndrome differentiation for 186 gastric cancer patients and 300 colorectal cancer patients. Results: Among gastric cancer patients, the spleen deficiency with blood stasis and toxin syndrome was the most prevalent. This syndrome in gastric cancer showed no significant correlation with gender, pathological stage, routine blood tests (RBC, Hb, WBC, absolute neutrophil count, PLT), routine stool examination, biochemical indicators (AST, ALT, Scr, BUN), tumor markers (CEA, CA19-9, AFP, CA72-4, CA125), abdominal pain, abdominal distension, stool characteristics, belching, acid regurgitation, or nausea and vomiting. Among colorectal cancer patients, the spleen deficiency with blood stasis and toxin syndrome was also the most prevalent. This syndrome in colorectal cancer showed certain correlations with CEA, CA19-9, stool characteristics, abdominal mass, and borborygmi. However, it showed no significant correlation with pathological stage, routine blood tests (RBC, Hb, WBC, absolute neutrophil count, PLT), routine stool examination, biochemical indicators (AST, ALT, Scr, BUN), AFP, CA72-4, CA125, abdominal pain, abdominal distension, or flatus. Conclusion: The spleen deficiency with blood stasis and toxin syndrome is the primary TCM syndrome in gastrointestinal malignancies and exhibits certain correlations with CEA, CA19-9, stool characteristics, abdominal mass, and borborygmi.

Key words：gastrointestinal malignancies; gastric cancer; colorectal cancer; traditional Chinese medicine syndromes; pathogenesis theory of cancerous toxin

发布时间：2026-03-05

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