吴泳蓉 何清湖 周青 田雪飞

〔摘要〕 运用中医治未病思想预防前列腺癌的发生、发展及术后复发对于降低前列腺癌的发病率及死亡率具有积极的指导意义。前列腺癌治未病全程防治体系将从预防前列腺癌高危因素、防止癌前病变向前列腺癌转化、延缓激素依赖性前列腺癌向去势抵抗性前列腺癌转化、延缓晚期前列腺癌进展、提高晚期前列腺癌生存质量五方面全方位构建。依据中医“未病先防、欲病救萌、已病防变、瘥后防复”四大治未病核心思想为切入点，围绕前列腺癌高危态、癌前态、前列腺癌晚期状态及术后防复发状态等基本状态的防治思路进行展开论述，以期为前列腺癌防治体系的构建提供一定的指导思路。

〔关键词〕 前列腺癌;治未病;全程防治;去势抵抗性前列腺癌

〔中图分类号〕R273       〔文献标志码〕A        〔文章编号〕doi：10.3969/j.issn.1674-070X.2021.12.026

Discussion on the Guidance of the Whole Prevention and Treatment of Prostate

Cancer by the Thought of Chinese Medicine Prevention of Disease

WU Yongrong1， HE Qinghu1，2， ZHOU Qing3， TIAN Xuefei1*

（1. College of Integrated Chinese and Western Medicine， Hunan University of Chinese Medicine， Changsha， Hunan 410208， China; 2. Hunan University of Medicine， Huaihua， Hunan 418000， China; 3. The First Affiliated Hospital of Hunan

University of Chinese Medicine， Changsha， Hunan 410007， China）

〔Abstract〕 It is of positive guiding significance to prevent the occurrence， development and postoperative recurrence of prostate cancer with the thought of preventing disease. The whole-course prevention and treatment system for prostate cancer will be constructed from five aspects： preventing the high-riskfactors of prostate cancer， preventing the transformation from precancerous lesions to prostate cancer， delaying the transformation from hormone-dependent prostate cancer to castration resistant prostate cancer， delaying the progress of advanced prostate cancer， and improving the quality of life of advanced prostate cancer. On the basis of the traditional Chinese medicine "prevention before disease， prevention the coming disease， stopping the progress of disease， prevention of the recrudescence of disease" four core idea of preventing disease as the breakthrough point， around a high risk of prostate cancer and precancerous states， state of advanced prostate cancer and postoperative recurrence and other basic state， the prevention and control of ideas for prostate cancer prevention and control system of the building will provide certain guiding mentality.

〔Keywords〕 prostate cancer; preventive treatment of disease; whole-course prevention; castration resistant prostate cancer

前列腺癌（prostate cancer， PCa）在我國发病率呈现上升趋势，且增长比欧美国家要迅速，严重影响男性的预期寿命及生存质量[1-2]。PCa具有发病因素复杂多样[3]，起病隐匿[4]，大多数患者确诊时已发展至中晚期状态[5]，晚期激素依赖性PCa易向去势抵抗性前列腺癌（castration resistant prostate cancer， CRPC）转化等综合特点[6]。因此，构建全方位的PCa的防治体系，多维度预防PCa的发生、发展是亟待解决的临床及社会问题。本课题组认为，干预PCa高危因素、防止癌前病变向PCa转化、截断激素依赖性PCa向CRPC转化，延缓晚期PCa进展，提高生存质量是全方位构建PCa防治体系的核心内容。中医治未病思想涵盖“未病养生、防病于……