肝癌病機之中醫文獻回顧

Study of the Chinese Medical Literature on the Pathogenesis of Hepatocellular Carcinoma

肝癌在國人癌症死因中佔第一位，但在藥物治療上仍無確實有效的方法。本研究希望從文獻回顧中，對肝癌病機作深入的分析。研究中選用「北京中國中醫科學院中醫藥期刊文獻資料庫」及「中國期刊網全文資料庫」兩大中醫近代文獻資料庫作為材料，以「肝癌」為關鍵字進行搜尋，並以「中醫」或「中藥」限制搜尋範圍。結果顯示，學者們對於肝癌病因、病機之觀點大致相近。在病因上，重要外因為濕熱毒邪，不論是肝炎病毒、飲水污染及黃鞠毒素均被視為濕熱毒邪，而飲酒過度與吸煙為加重濕熱毒邪之因素；內因上以情志抑鬱導致肝氣不疏、勞倦或飲食所傷導致脾氣虛及正氣不足為主。肝癌形成的病機主要為濕熱毒邪鬱於肝脾，造成肝鬱脾虛，更使體內易生痰濕；而情志抑鬱、脾氣虛、正氣不足均使氣血運行不暢，痰濕不易袪除，日久氣滯血瘀、濕熱痰毒互結形成肝癌。此結果有助於從傳統醫學正確認識肝癌病機，將可提供臨床治療與研究之參考。

Although hepatocellular carcinoma (HCC) is the leading cause of cancer-related death in Taiwan, there is still no effective treatment until now. Hence, we aimed to analyze the pathogenesis of HCC in Chinese medicine by reviewing the Chinese medical literature, in order to provide a reference for both the clinical practice and research. We chose “Hepatocellular carcinoma” as the key word to search the “Traditional Medical Database of Beijing Chinese Medical Academy” and “China Journal Full-text Database”, and limited the searching by the term “Chinese Medicine” or “Chinese herb”. The results of the analysis of the etiology and pathogenesis of HCC in Chinese medicine are as the followings. Main environmental factors, such as: hepatitis virus, polluted water, and aflatoxin are viewed as “Wet-Heat pathogenic factor”, whose influence is aggravated by alcoholism and smoking. Unbalanced emotional status, unhealthy diet habits, and work over-load all worsen the constitution and make the body liable to the pathogenic factors. The pathogenesis of HCC begins with the invasion of the pathogenic factors disturb the normal function of the “liver zang” and “spleen zang”, and finally give rise to the formation of the mixture of stasis of chi, blood, and fluid in the “liver zang”.