郭志强教授之宫颈微癥瘕理论简介

陈玥 张家蔚 严培嘉 李军

摘要 总结郭志强教授治疗宫颈癌前病变的经验。郭志强教授提出了“宫颈微癥瘕”的学术理论，认为宫颈癌前病变系由正气亏虚，湿、热、毒、瘀之邪共同蕴结于子门，日久形成宫颈微癥瘕，临床采用扶正祛毒之法治疗此病，标本同治，疗效显著。

关键词 宫颈微癥瘕;宫颈癌前病变;宫颈上皮内瘤变;正虚邪实;扶正祛毒;标本同治;名医经验; @ 郭志强

Abstract The paper summarized Professor GUO Zhiqiang′s experience in treating cervical precancerous lesions.Professor Guo Zhiqiang put forward the academic theory of “cervical micro-ZhengJia”.He believes that cervical precancerous lesions are caused by the deficiency of vital qi，and the pathogenic factors of dampness，heat，toxin and blood stasis gather together in the cervix and form cervical micro-ZhengJia over time.This disease is treated with the method of strengthening the body and removing toxin.It treats both the symptoms and the root causes and the curative effect is remarkable.

Keywords Cervical micro-ZhengJia; Cervical precancerous lesions; Cervical intraepithelial neoplasia; Asthenia of healthy qi and sthenia of pathogenic factor; Strengthening the body and removing toxin; Treating both the symptoms and the root causes; Experience of famous doctors; @ GUO Zhiqiang

中图分类号：R271.9;R737.3文献标识码：Bdoi：10.3969/j.issn.1673-7202.2021.24.017

宫颈癌是当前最常见的女性生殖系统恶性肿瘤，2018年全球新发宫颈癌病例约57万例，死亡约31万例[1]。近年来，宫颈癌的发病人群有年轻化趋向，严重威胁着广大女性的生命健康[2]。研究表明宫颈癌最主要的发病原因是高危型人乳头瘤病毒（HR-HPV）的持续感染，同时不良性行为、孕产次数多、吸烟、口服避孕药、机体免疫功能低下等是其发病的危险因素[3-5]。从HR-HPV感染到宫颈癌前病变最终发展为宫颈癌是临床上一种渐进的演变过程。宫颈癌前病变分为低级别鳞状上皮内瘤变（LSIL）与高级别鳞状上皮内瘤变（HSIL），而临床上大多数LSIL可自然消退，少部分LSIL和大多数HSIL在10～15年可能发展为宫颈癌[6-7]。因此在宫颈癌前病变阶段进行有效的干预对宫颈癌的预防具有重大作用。现代医学对于宫颈癌前病变的处理综合考虑其病变程度、患者年龄、细胞学及HPV检测结果、阴道镜检查情况及是否需要保留生育功能等因素。对于组织病理学确诊的LSIL大多建议随访观察，HSIL可根据情况选择消融性（冷冻、激光、电凝等）或切除性治疗（宫颈环形电切术、冷刀锥切术等）[8-9]。……