恶性胸腔积液的机制研究进展及中医药干预靶点的思考  

Mechanism Study Progress on Malignant Pleural Effusion and Reflection on Intervention Targets in TCM

作　　者：金志超[1] 施展[2] 花宝金[1] 

机构地区：[1]中国中医科学院广安门医院肿瘤科,北京100053 [2]中国中医科学院中医临床基础医学研究所,北京100700

出　　处：《世界中西医结合杂志》2017年第1期11-17,共7页World Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金(81603610);国家"十二五"科技支撑计划(2014 BAI10B01)

摘　　要：恶性胸腔积液(MPE)是晚期肿瘤常见的并发症,严重影响患者生活质量,预后较差。MPE的形成机制尚不明确,近年来随着研究深入,对MPE形成的病理过程也有了新的认识,除了淋巴管堵塞外,肿瘤新生血管、血管通透性增高、局部炎症以及水通道蛋白等也参与了MPE的形成。目前MPE的治疗方法虽多,但总体疗效有限,中医药对MPE具有一定干预作用。但目前还存在一些问题,如总体机制研究偏少,对作用靶点、有效成分的阐述尚显不足;研究多以复方为主,缺少对单药、拆方、组方的研究;中医药治疗具有"多系统、多靶点"的特点,仅仅局限于某一靶点或某一机制无法全部诠释中医药的治疗机制;中医药治疗MPE有着深厚的理论基础,依据该理论指导临床治疗有着切实的疗效,如何将中医的"利水逐饮"的治疗思想与现代医学的机制研究相结合,是目前尚未涉及的地方。Malignant pleural effusion（ MPE） is the common complication of advanced tumor and it seriously affects the living quality of patients and has poor prognosis. The mechanism on the formulation of MPE is unclear. In recent years,with the research deepening,there is the new recognition on the pathological process of MPE. Except for lymphatic block,tumor angiogenesis,the increased vascular permeability,local inflammation and aquaporins are also participated in the occurrence of MPE. Currently,there are many therapeutic methods for the treatment of MPE,but the overall effects are limited. TCM has a role on the intervention of MPE and still has some problems such as limited study on the general mechanism and the explanation on effect target and effective component; specially focusing on the study of compound formulas rather than single herb,separating formula and combined formula. TCM is characterized as ＂ multi-system and multi-target＂. If only limiting on some target or mechanism,it is unable to elaborate the therapeutic mechanism of TCM. TCM has profound theoretic foundation in the treatment of MPE,which may guide the clinical practice and achieve definite effects. Till now,the consideration should be on how to combine the therapeutic idea of TCM as ＂benefiting water and removing harmful fluids＂with the mechanism study of modern medicine.

关 键 词：恶性胸腔积液 血管生成 血管通透性 微环境 机制 中医药 

分 类 号：R730.53[医药卫生—肿瘤]