基于“邪伏肠络”理论探讨结直肠炎癌转化的动态演变机制及治疗思路

Dynamic Evolution Mechanisms and Therapeutic Strategies of Colorectal Inflammation-Cancer Transformation Based on “Pathogen Latent in Intestinal Collaterals” Theory

摘要: 结直肠炎癌转化是炎症性肠病迁延不愈进展为结直肠癌的核心病理过程，也是临床防治结直肠癌的关键窗口期，现代医学对其干预仍存在靶点单一、不良反应多、远期防治效果有限等局限。“邪伏肠络”理论源于中医伏邪学说与络病理论的融合，精准契合结直肠炎癌转化隐匿起病、缠绵难愈、渐进恶变的病理特点。本文系统梳理“邪伏肠络”的理论渊源与核心内涵，将其与脾虚、湿热、血瘀等传统核心病机进行比较辨析，阐释“邪伏肠络”理论的学术优势与不可替代性。基于该理论阐释结直肠三期动态演变机制，对应提出分阶段治疗思路，并结合炎癌转化不同阶段探讨中西医结合治疗的可行路径与中医治疗定位，以期为中医药防治结直肠炎癌转化提供新的理论视角与临床实践指导。

Abstract: Colorectal inflammation-cancer transformation is the core pathological process through which inflammatory bowel disease (IBD) progresses into colorectal cancer due to persistent and intractable inflammation, and it also represents a critical window period for the clinical prevention and treatment of colorectal cancer. However, modern medical interventions for this process still face limitations such as single target selection, numerous adverse reactions, and limited long-term prevention and treatment efficacy. The theory of “Pathogen Latent in Intestinal Collaterals” originates from the integration of the TCM theory of latent pathogenic factors and collateral disease theory, and it accurately aligns with the pathological characteristics of colorectal inflammation-cancer transformation, including insidious onset, lingering and intractable course, and progressive malignant transformation. This paper systematically sorts out the theoretical origin and core connotation of “Pathogen Latent in Intestinal Collaterals”, compares and analyzes it with traditional core pathogenesis such as spleen deficiency, dampness-heat and blood stasis, and expounds the academic advantages and irreplaceability of this theory. On this basis, the three-stage dynamic evolution mechanism of colorectal cancer is expounded, stage-specific therapeutic strategies are proposed, and the feasible paths of integrated traditional Chinese and Western medicine treatment and the positioning of TCM therapy at different stages of inflammation-cancer transformation are discussed, aiming to provide new theoretical perspectives and clinical practice guidance for TCM prevention and treatment of colorectal inflammation-cancer transformation.