中医药逆转抗肿瘤药物耐药的机制探讨  

Study on Mechanisms of Reversing Antineoplastic Drug Resistance by Traditional Chinese Medicine

作　　者：张悦 林怡 陶丽[1] ZHANG Yue;LIN Yi;TAO Li(Longhua Hospital Affiliated to 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：《中华中医药学刊》2023年第5期183-189,共7页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82174450);国家“重大新药创制”科技重大专项(2017ZX09304001)。

摘　　要：抗肿瘤药物的耐药性是导致其治疗失败的主要原因。大量研究资料已经证明,中医药在逆转抗肿瘤药物耐药方面具有良好优势。从中医的整体观念和辨证论治出发,提出了肿瘤耐药的中医理论构想:荷瘤的肿瘤患者是瘤体和机体的共生共存的有机整体,机体之虚与瘤体之盛往往贯穿于肿瘤的发生发展,且在耐药的恶性肿瘤中突出体现。于机体而言,机体之虚一方面导致气血生化乏源,卫气充养不足,抵御外邪之力日趋下降,进而致使癌毒持续存在;另一方面还可造成气化功能失常,物质代谢和能量转换异常,致使顽癌长生不亡。机体之虚又分为气血阴阳之虚,落实到脏腑上多为脾肺之虚与肾虚。于瘤体而言,肿瘤属于癥瘕积聚,是气滞、痰浊、血瘀、热毒诸邪相互胶着,日久而成。肿瘤内邪气越盛,则肿瘤自身的防御能力越强。主要从机体之虚(脾肺之虚、肾虚)及瘤体之盛(气滞、血瘀、痰浊、热毒)来阐述对肿瘤耐药的认识以及中药逆转抗肿瘤药物耐药的研究。The resistance of antineoplastic drugs is the main reason for therapy failure.A large number of researches have proved that traditional Chinese medicine(TCM)has good advantage on reversing anti-tumor drug resistance and improving the quality of life of patients after surgery.Based on the holism and syndrome differentiation of TCM,it put forward the theoretical conception of TCM for tumor resistance:tumor patients are the organic whole of symbiosis and coexistence of tumor and body.The deficiency of body and the prosperity of tumor often run through the occurrence and development of tumor,and are highlighted in the malignant tumor with drug resistance.On the one hand,body deficiency leads to lack of biochemical source of Qi and blood,insufficient nourishing of Wei Qi,declining ability to resist external evil and continuous existence of cancer toxin.On the other hand,it can also cause abnormal Qi movement,abnormal metabolism and energy conversion,resulting in persistent cancer.The deficiency of body is divided into deficiency of Qi,blood and Yin and Yang,which is mostly deficiency of spleen,lung and kidney when it comes to Zang-Fu organs.As far as the tumor body is concerned,the tumor belongs to the accumulation of the body mass,which is formed by the mutual adhesion of Qi stagnation,phlegm turbidity,blood stasis and heat toxin over time.The stronger the evil in the tumor,the stronger the defense ability of the tumor itself,which promotes the survival of tumor cells.This article mainly expounded the understanding of drug resistance of tumor and the research on reversal of drug resistance of anti-tumor drugs by TCM from the aspects of the deficiency of the body(spleen and lung,kidney)and the exuberance of tumor(Qi stagnation,blood stasis,phlegm turbidity,heat toxin)

关 键 词：抗肿瘤药物耐药 中医病机 中药 机制探讨 

分 类 号：R282[医药卫生—中药学]