摘要
肿瘤微环境作为肿瘤赖以生存的环境基础,具有免疫抑制、缺血缺氧、代谢重编程、炎症浸润等特征,为肿瘤细胞的定植、恶变和迁移提供了条件支持。中医学认为阳气与肿瘤的发病密切相关,基于中医学“痞坚之处,必有伏阳”,提出由阳气异常所形成的“伏阳”状态与肿瘤微环境高度相似。伏阳失护,导致正向免疫减弱,病邪侵入,积聚始生;伏阳郁遏,造成微循环障碍,脉络不通,气血闭阻;伏阳生浊,聚集异常代谢产物,浊邪蓄积,搏结成瘤;伏阳化火,介导“炎-癌”转化,火热炽盛,癌瘤恶变;伏阳成毒,促成预转移龛,正虚毒结,癌毒流注。结合“伏阳”理论及现代研究,总结提出以“温阳益气以固本、通阳行气以祛瘀、助阳化气以除弊、疏阳开郁以散火、扶正清源以截毒”之法对肿瘤微环境加以干预,以期为中医药重塑肿瘤微环境、调控肿瘤进程提供新思路。
As the environmental foundation for tumor survival,the tumor microenvironment is characterized by immunosuppression,ischemia and hypoxia,metabolic reprogramming,and inflammatory infiltration,providing con⁃ditions for tumor cell colonization,malignant transformation and migration.In traditional Chinese medicine(TCM),yang qi is considered to be closely related to the onset of tumors.Based on the TCM theory of“where there is mass hardness,there must be latent yang”,this paper suggests that the state of“latent yang”formed by abnormal yang energy is highly similar to the tumor microenvironment.The loss of protection of latent yang leads to the weakening of positive immunity,invasion of disease and then accumulation of tumors.The constraint of latent yang leads to micro⁃circulation disorders,blocked vessels and collaterals,and finally qi and blood blockage.The turbidity of latent yang leads to abnormal metabolic products gathering,pathogenic turbidity accumulation,and tumor formulation through contention and binding between them.The transformation of fire by latent yang mediates“inflammation-cancer”trans⁃formation,and leads to malignant transformation of cancerous tumors.The transformation of latent yang into toxin leads to premeditated pre-metastatic niches,healthy qi deficiency and toxin accumulation,and cancerous toxins flow.Based on the theory of“latent yang”and modern researches,this paper summarized the method of“warming yang and invigorating qi to consolidate the root,promoting yang and moving qi to eliminate stasis,strengthening yang capacity of transforming qi to remove the disadvantages,diffusing yang and opening up constraint to disperse fire,and reinforcing healthy qi and clearing the source to prevent toxins”in the intervention of the tumor microenvironment,so as to provide ideas for TCM to reshape the tumor microenvironment and regulate the tumor process.
作者
戴义宁
李慧杰
李秀荣
DAI Yining;LI Huijie;LI Xiurong(Shandong University of Traditional Chinese Medicine,Jinan,250013;The Affiliated Hospital of Shandong University of Traditional Chinese Medicine)
出处
《中医杂志》
CSCD
北大核心
2023年第22期2275-2281,共7页
Journal of Traditional Chinese Medicine
基金
山东省自然科学基金(ZR2021LZY029)。
关键词
肿瘤微环境
阳气
痞坚
伏阳
tumor microenvironment
yang qi
mass hardness
latent yang
