Wen | Wu SirEditor | Eucommia ulmoidesAt present, the etiology of intestinal polyps is not yet clear. Research suggests that risk factors for intestinal polyps include Helicobacter pylori infection, proton pump inhibitors, physicochemical factors, genetic factors, environment, diet, and lifestyle habits

Wen | Wu Sir

Editor | Eucommia ulmoides

At present, the etiology of intestinal polyps is not yet clear. Research suggests that risk factors for intestinal polyps include Helicobacter pylori infection, proton pump inhibitors, physicochemical factors, genetic factors, environment, diet, and lifestyle habits.

Cold loop polypectomy is mainly used for the removal of small and small polyps, while techniques such as EMR and endoscopic submucosal dissection are used for the removal of large or large polyps.

Early pulmonary nodules often have no specific symptoms and signs, and are more often discovered during chest X-ray or chest CT examination during physical examination. According to density, pulmonary nodules can be divided into three categories: ground glass nodules, partially solid nodules, and solid nodules.

Surgery is the main treatment for malignant pulmonary nodules. However, there is currently no consensus on the monitoring and diagnosis and treatment strategies for pulmonary nodules of unknown nature.In recent years, pulmonary intestinal comorbidities have become a hot topic in clinical research.

Clinically, it is common for patients with intestinal polyps to have pulmonary nodules. Under the guidance of the concept of "treating diseases before they occur", early intervention and treatment for pulmonary and intestinal diseases can improve clinical prognosis.

The Theoretical Basis and Origin of Traditional Chinese Medicine on the Relationship between Lung and Large Intestine

The understanding of the relationship between the lungs and the large intestine by ancient medical experts has a long history, and the relationship between the two is mainly reflected in three aspects: meridians, physiological functions, and pathology.

In the aspect of channels and collaterals, the Huangdi Neijing said: "The lung joins the large intestine, and the large intestine is the transmission organ", which was the first to put forward the exterior interior relationship between the lung and the large intestine.

The "Lingshu Meridian" states: "The meridian of the Taiyin in the lung and hand originates from the middle energizer, descends on the large intestine, and also runs along the stomach." "The meridian of the Yangming in the large intestine belongs to the large intestineThe close collateral relationship between the lungs and the large intestine along the meridians was proposed.

In addition, the "Lingshu Meridians" states that "the meridian of the lung and hand Taiyin originates from the end of the big finger, and the meridian of the large intestine and hand Yangming originates from the end of the big finger." The sequential flow of qi and blood through the external and internal meridians also reflects the unity between the lung and the large intestine.

In terms of physiological functions, the lungs regulate qi, regulate respiration, and promote the dissemination and purification of lung qi are the foundation and prerequisite for promoting the intestinal tract to exert its metabolites; At the same time, the large intestine transmits chemicals without hiding them, and the peristalsis of the large intestine also helps to eliminate and eliminate turbid qi in the lungs.

As Huang Yuanyu said, "The lungs and the large intestine share the same qi on the surface and inside. The lung qi transforms into essence and nourishes the large intestine, making the intestines smoother and easier to defecate

The Essential Meaning of the Medical Classic - The Officials of the Zang and Fu Organs "states:" The lung qi transports the large intestine, regulates the body fluid, and governs the regulation of the joints. When the joints go down, the qi is smooth and the rest is peaceful, and the bowel movements are regulated. The reason why the large intestine is transmitted is because it is the organ of the lung, and the lung qi is transmitted, so it can be transmitted

Liu Tiejun, Liu Sheng and others believed that the lung and large intestine both originated from the Endoderm of the original digestive tube in terms of Embryology.

At the same time, it is believed that the lungs and large intestine in the "lung to large intestine" system are not only functionally interconnected, but also have temporal synchronization with the ileum and colon in embryonic histology.

In terms of pathology, the "Su Wen Ke Lun Pian" states: "If the lung coughs continuously, the large intestine receives it. The large intestine coughs like a cough, but the cough is left behindThis indicates that coughing for a long time can affect the large intestine, while prolonged coughing can lead to symptoms such as incontinence.

Volume V of the Notes to the Lingshu Collection of the Huangdi Neijing says:The large intestine is the organ of the lungs that governs bowel movements, causing pathogenic obstruction in the large intestine. Therefore, the upper part is characterized by asthma. Therefore, diseases of the large intestine can also persist in the lungs

It indicates that the lungs and large intestine interact with each other in pathology. If the lung qi loses its ability to nourish the large intestine, or if the lung qi is weak, it can lead to the disorder of descending and descending, and the turbid qi remains in the middle energizer, affecting the patency of the fu qi, it can be seen that defecation is difficult.

If the large intestine is hot and the internal qi is obstructed, the turbid qi in the intestines will go against the lungs, causing obstruction of the lung qi and causing coughing, coughing, and suffocation in the lungs.

Therefore, for patients with lung and intestinal diseases, treating the lung or intestine alone is difficult to determine its source. It is necessary to treat both lung and intestine, guide according to the situation, and induce pathogenic factors to resolve.

Understanding of intestinal polyps and pulmonary nodules in Traditional Chinese medicine

Etiology, pathogenesis and syndrome differentiation of intestinal polyps. There is no name of "Colorectal polyp" in the ancient medical books, which can belong to the categories of "intestinal polyps", "intestinal polyps", "accumulation" and "intestinal tumors".

According to the nomenclature of diseases in Traditional Chinese medicine, some modern Chinese medicine experts took "Colorectal polyp" as the name of a disease in traditional Chinese medicine.

The chapter of "Lingshu - Water Swelling" states, "How about Chang Qin? Qibo said," Cold Qi is external to the intestines, competing with Wei Qi. Qi is not honored, but due to its connections, it becomes internal due to addiction. Evil Qi arises, and polyps arise

It indicates that cold energy first invades the surface of the human body. As the condition progresses, evil energy enters the body over time, and the good and evil compete. If qi stagnation and blood stasis occur, pathological products gather and become polyps.

The Criterion of Syndrome and Treatment - Miscellaneous Diseases ":" The husband's intestines are the large intestine, and the qin is the extension. The large intestine is responsible for conduction, which is the organ of the lungs. The lungs control the health, and the wei is the qi. When heat is obtained, it releases, and when cold is obtained, it coagulates. Nowadays, the cold guest is in the large intestine, so the qi of the health is not honored. If there is a connection and it is stuck inside, it is called the intestine qin. "Among them, the jie jia is attached inside, which is the manifestation of colorectal polyps.

Due to the numerous pathological factors involved in colorectal polyps, and the different triggering factors at different stages,Therefore, there is no unified understanding of the etiology, pathogenesis and syndrome differentiation in Traditional Chinese medicine.

Ma Xiaolin et al. divided Colorectal polyp into three types: spleen deficiency and dampness accumulation, damp heat accumulation, spleen kidney yang deficiency and phlegm blood stasis.

Han Ling and others classified the causes of this disease as qi stagnation, blood stasis, and dampness heat,And on this basis, the syndrome types are divided into qi and yin deficiency, spleen deficiency with internal accumulation, phlegm and blood stasis, qi stagnation and blood stasis, and kidney deficiency with blood stasis.

He Gongda et al. summarized the etiology and pathogenesis of colonic polyps as emotional factors, leading to liver stagnation and qi stagnation. If liver stagnation multiplies with the spleen, the spleen loses its healthy circulation, the ascending and descending circulation loses control, and the invasion of dampness and heat toxins leads to the accumulation of phlegm and dampness.

Or improper diet, a preference for fat, sweet, and thick flavors, the evil of phlegm and dampness stays in the large intestine, and accumulates with dirt and debris in the intestine, resulting in polyps.In addition, in terms of constitution identification, Yu Chunyue and others believe that the constitution prone to Colorectal polyp is phlegm damp and damp heat.

The etiology, pathogenesis and syndrome differentiation of pulmonary nodules are rooted in Traditional Chinese medicine. According to the clinical manifestations, pulmonary Sarcoidosis is classified into "lung accumulation", "rest and cardia", "lung cough" and other categories.

For the description of "lung accumulation", as stated in the "Pulse Meridian - Ping Wu Zang Accumulation Meridian Syndrome": "It is diagnosed that the lung accumulation pulse is floating and hairy, and according to it, the qi under the pressure is reversed, causing pain in the back phase, lacking qi, being forgetful, with eyes closed, the skin is cold and the skin is sometimes painful, like a lice beak, or even like acupuncture, itching, and its color is whiteThere are also different viewpoints on the etiology, pathogenesis, and syndrome differentiation of pulmonary nodules.

According to Zhu Lina and others, the basic pathogenesis of pulmonary nodules is the deficiency of qi and excess of evil. Deficiency of qi leads to an imbalance of qi, blood, yin, and yang, dysfunction of visceral functions, and the influx of evil energy.

Causing weakness of lung qi, loss of circulation, accumulation of phlegm, phlegm coagulation and qi stagnation, and accumulation of phlegm and blood stasis. Over time, it becomes nodules. Therefore, the treatment of this disease is to support the right and eliminate pathogenic factors.

Zhao Yuanchen et al. believe that the etiology and pathogenesis of pulmonary nodules mainly lie in the obstruction of phlegm and qi, as well as the obstruction of qi flow. Prolonged course of disease can lead to long-term stasis and the accumulation of phlegm and blood stasis.

The causes of pulmonary nodules are often insufficient endowments, poor emotions, unclean drinking, eating, and living, as well as chronic lung disease that persists and cannot be cured.

Zhang Xiaomei et al. believe that qi stagnation and dampness obstruction, as well as phlegm stasis stagnation, are the basic pathogenesis of pulmonary nodules. For example, external pathogenic haze toxins damage the lungs, leading to depletion of lung qi. Firstly, the qi mechanism of the lungs is damaged, water dampness stagnates, and then leads to phlegm turbidity and blood stasis coagulation, gradually transforming into pulmonary nodules.

The mechanism of action of pulmonary intestinal syncretic disease

In recent years, Gut microbiota has become one of the important focuses in the research of digestive system diseases. The bacterial communities in the lung and intestinal tissues jointly participate in many physiological and pathological processes within the body.

In the event of imbalance in the local bacterial community of the body, changes in the bacterial community of other parts will also occur.

Zheng Xurui and others found that if the lung system changes, the Gut microbiota will have reactive changes, whereas if the intestinal tissue changes, the pulmonary flora will also have reactive changes.

Zhang Liangdeng et al. found that patients with lung disease had imbalance of Gut microbiota, obvious constipation, loose stools and other digestive tract symptoms, and there was a trend of lung and bowel disease.The mucous membranes of the gastrointestinal tract and respiratory tract are both part of the common mucosal immune system.

The intestinal Mucosa-associated lymphoid tissue is the primary barrier against infection in the human body, and the intestinal mucosal immune system is an important part of the mucosal immune system of the body. The intestinal Mucosa-associated lymphoid tissue is interconnected.

Local mucosal immune response can occur through the phenomenon of "homing" of effector lymphocytes, resulting in varying degrees of immune response in different parts of the mucosa.

Embryology studies have confirmed that the lungs and trachea are derived from the foregut of the gastrula,The Epithelium and glands of the respiratory tract are differentiated from the gastral Endoderm, which indicates that the lung tissue and intestinal tissue are synchronized in Embryology.

The defense of the respiratory system depends on both the intestinal tract and Respiratory epithelium immunity. Research shows that intestinal segmented filamentous bacteria can stimulate the body to produce Th17 immune cells and reduce the risk of Streptococcus pneumoniae infection.

Mice inoculated with Lactobacillus yoelii can significantly reduce Th2 type inflammatory response in the lungs;Strains expressing cytotoxic associated gene A can help the body improve asthma symptoms.

The common Endocrine system mainly includes thyroid, pituitary and other endocrine related organs and tissues. However, the intestine is also a complex endocrine organ in the body. Substances secreted by the intestine have been proven in many studies to affect respiratory function.

For example, the Vasoactive intestinal peptide secreted by H cells in the ileum colon can stimulate breathing and relax the trachea, thus inducing hyperventilation.

In addition, ganglia and Nerve plexus are widely distributed in lung and intestinal tissues, so the nervous system may also be an important medium of lung gut interaction.

As Yang Shenglan and others discovered, after administering traditional Chinese medicine to tonify lung qi in a rat model of lung qi deficiency,With the recovery of intestinal dynamics, the Enteric nervous system is excited, indicating that there is a nervous system between the lung and the intestine involved in mediation and regulation.

In recent years, many Chinese medicine clinical workers and researchers have applied the theory of "lung and large intestine are external and internal" to the clinical treatment of pulmonary and intestinal diseases.For example, Zhang Yingqian and others used rhubarb to treat children with Respiratory failure and gastrointestinal dysfunction.

It was found that rhubarb can improve the oxygenation index of children while restoring gastrointestinal function to normal state. It is suggested that treating respiratory diseases can improve gastrointestinal function.

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