“从化”学说指导下探讨乳腺癌肺、骨转移的组方原则及对巨噬细胞极化的影响  

Formulation principles of breast cancer lung and bone metastasis and their effects on macrophage polarization under the guidance of‘Conghua’theory

作　　者：张洋[1] 杨瑞 史有阳 王怡 李斐斐 杨小娟 韩向晖[1] 刘胜[1] ZHANG Yang;YANG Rui;SHI You-yang;WANG Yi;LI Fei-fei;YANG Xiao-juan;HAN Xiang-hui;LIU Sheng(Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200032,China)

机构地区：[1]上海中医药大学附属龙华医院,上海200032

出　　处：《中华中医药杂志》2022年第5期2794-2798,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家自然科学基金面上项目(No.81774308);高水平大学团队建设高峰高原创新团队(No.601521D)。

摘　　要：目的:在中医“从化”学说指导下探讨乳移平、温肾壮骨方干预乳腺癌肺、骨转移的作用以及对巨噬细胞极化的影响。方法:构建小鼠乳腺癌肺、骨转移模型,均分为模型组、乳移平组、温肾壮骨方组,给药过程中记录小鼠体质量,肿瘤大小,给药结束后对两种小鼠模型的转移情况进行评价,流式细胞术检测肺、骨转移灶中M2/M1型巨噬细胞比例变化,苏木精-伊红染色观察肺、骨转移灶结构差异,免疫组织化学染色观察肺、骨转移灶中巨噬细胞浸润情况。结果:乳腺癌肺转移小鼠中,乳移平和温肾壮骨方皆能够抑制重量,降低肺转移结节数(P<0.05,P<0.01),但乳移平组抑瘤效果优于温肾壮骨方组(P<0.05,P<0.01)。乳移平可降低肺转移灶中M2/M1的比例(P<0.05)。乳腺癌骨转移小鼠中,温肾壮骨方能抑制骨转移灶数量(P<0.05,P<0.05),两个用药组肿瘤负荷与M2/M1的比例均较模型组低,且温肾壮骨方效果优于乳移平(P<0.05,P<0.01)。结论:“从化”学说指导下的组方用药对不同病机的乳腺癌肺、骨转移具有一定疗效;乳腺癌肺转移宜“散结解毒”,乳腺癌骨转移宜“温肾壮骨”。Objective:To explore the effects of Ruyiping Formula(RYP)and Wenshen Zhuanggu Formula(WAZG)on interving breast cancer lung and bone metastasis,and its mechanism of macrophage polarization under the guidance of‘Conghua’theory.Methods:Breast cancer lung metastasis model and bone metastasis model were constructed,which were divided into model group,RYP group and WSZG group.The weight and tumor size of the mice were recorded during treatment.After the course of treatment,the metastasis of both mouse models were evaluated.Flow cytometry was used to detect changes in the ratio of M2/M1,HE staining to observe structural differences,and IHC staining to observe macrophage infiltration in lung and bone metastasis.Results:In mice with breast cancer lung metastasis,both RYP and WSZG can inhibit the tumor weight,and reduce the number of lung metastasis nodules(P<0.05,P<0.01).However,the tumor suppressive effect in the RYP group was better than that in the WSZG group(P<0.05,P<0.01).RYP decreases the proportion of M2/M1 in lung metastasis(P<0.05).In mice with breast cancer bone metastasis,WSZG could inhibit the number of bone metastases(P<0.05).However,the ratio of tumor burden and M2/M1 in both treatment groups was lower than that in the model group,and the effect of WSZG was better than that of RYP(P<0.05,P<0.01).Conclusion:Prescription composition under the guidance of‘Conghua’theory has a certain efficacy for different pathogenesis of breast cancer lung and bone metastasis.Therapeutic rules of breast cancer lung metastasis ought to‘dissolve knots and detoxification’,while treatment for breast cancer bone metastasis is suitable for‘warm kidney and strengthen bones’.

关 键 词：“从化”学说 乳腺癌 肺转移 骨转移 巨噬细胞极化 乳移平 温肾壮骨方 肿瘤 

分 类 号：R285.5[医药卫生—中药学]