郭礼 周铖 杨林 司海龙 肖海娟

摘要 近年来很多研究发现大肠癌的发生与肠道菌群失调相关，通过调节肠道菌群可抑制大肠癌细胞的增殖，降低大肠癌的发病率。中医认为大肠癌基本病机为脾气亏虚，运化失常，气血生化乏源，正气渐衰，邪毒留聚，日久形成肿瘤，而相关研究表明肠道菌群的平衡与失调能够反映脾脏功能状态，在消化、吸收、免疫方面，二者关系密不可分，因此在大肠癌的治疗过程中，通过健脾法调节肠道菌群紊乱发挥着重要作用。现就健脾法调节肠道微生态的研究进展做，为进一步研究临床预防及治疗大肠癌提供参考。

关键词 健脾法;大肠癌;肠道微生态;脾虚证;调节;防治;研究进展

Research Progress on Regulating Intestinal Microecology of Colorectal Cancer by Strengthening Spleen

GUO Li1，ZHOU Cheng1，YANG Lin2，SI Hailong3，XIAO Haijuan3

（1 The First Clinical Medical Medical College，Shaanxi University of Chinese Medicine，Xianyang 712000，China; 2 Department of Hepa-tobiliary Surgery，Xian Yang Central Hospital，Xianyang 712000，China; 3 Department of Oncology，Affiliated Hospital of Shannxi University of Chinese Medicine，Xianyang 712000，China）

Abstract In recent years，many studies have found that the occurrence of colorectal cancer is closely related to the intestinal flora imbalance.By adjusting the intestinal flora，it can inhibit the proliferation of colorectal cancer cells and reduce the incidence of colorectal cancer.Traditional Chinese medicine believes that the basic pathogenesis of colorectal cancer is deficiency of spleen qi leading to the disorder of transportation and transformation and lack of the origin of producing qi and blood，declining healthy qi resulting in retention of pathogenic toxin，and the formation of tumors over time.And related studies show that the balance and imbalance of intestinal flora can reflect the functional status of the spleen.The two are inseparable in terms of digestion，absorption，and immunity.Therefore，in the treatment of colorectal cancer，the therapy of strengthening spleen plays an important role in regulating the disorder of the intestinal flora.This article reviews the research progress of the therapy of strengthening spleen to regulate intestinal microecology，and provides a reference for further research on clinical prevention and treatment of colorectal cancer.

Keywords Therapy of strengthening spleen; Colorectal cancer; Intestinal microecology; Spleen deficiency syndrome; Adjustment; Prevention and treatment; Research progress

中圖分类号：R273文献标识码：Adoi：10.3969/j.issn.1673-7202.2021.06.029

大肠癌（Colorectal Cancer，CRC）包括结肠癌和直肠癌，是常见消化道恶性肿瘤之一，2018年《CA：a cancer journal for clinicians》杂志报道，在全球范围内，结肠癌的发病率和死亡率分别位居第三位和第二位[1]。近年来，我国大肠癌的发病率和死亡率亦逐年升高，根据2019年1月国家癌症中心发布的全国癌症统计数据，2015年我国大肠癌粗发病率约为28.20/10万，死亡率高达13.61/10万[2]。大肠癌发病与众多因素相关，在微生物学研究领域，越来越多的研究发现肠道微生态在大肠癌的发生发展中起着重要作用[2-5]。而脾虚证是大肠癌的常见临床证型，脾为后天之本，主运化，输布水谷精微和津液以灌溉机体，与肠道菌群对营养物质的代谢利用功能相似，越来越多的研究发现健脾法可通过调节肠道菌群抑制结直肠癌的发生发展。……