扶正补益类中药在原发性肝癌中应用研究进展  

Application of Healthy Qi-reinforcing and Tonifying Chinese Medicines in Primary Liver Cancer:A Review

作　　者：高心宇 胡娟[1,2] 陈立武 GAO Xinyu;HU Juan;CHEN Liwu(The Second People′s Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou 350003,China;Clinical Research Institute,Institute of Integrative Traditional Chinese and Western Medicine,Fujian University of Traditional Chinese Medicine,Fuzhou 350003,China)

机构地区：[1]福建中医药大学附属第二人民医院,福州350003 [2]福建中医药大学中西医结合研究院临床研究所,福州350003

出　　处：《世界中医药》2023年第15期2231-2236,2242,共7页World Chinese Medicine

基　　金：国家自然科学基金项目(82174462);福建省自然科学基金项目(2020J01249)。

摘　　要：原发性肝癌(PLC)是目前我国第4位常见恶性肿瘤及第2位肿瘤致死病因。西医对肝癌的治疗方法较多,包括手术切除、移植、肝动脉化疗栓塞、无水乙醇瘤内注射、射频毁损治疗等,然而晚期肝癌往往伴有血管侵犯甚至远处转移,无手术切除等适应证,选择合适有效的全身治疗可延长晚期患者生存时间,改善生命质量。中医学认为PLC病机是本虚标实,正气亏虚是根本,癌毒入侵是关键。中医药治疗的优势在于对肝癌微环境多靶点、多环节、多通路的调节,其中扶正补益类方药在提高患者生命质量、延长生存时间、提高治疗效果和减少复发和转移等方面凸显了优势,可以提高患者生存率、改善机体功能,其作用机制可能是通过调节肠道菌群、提高机体免疫功能、影响肿瘤细胞的信号转导通路、诱导肝癌细胞凋亡、调控癌基因及抑癌基因的表达、抑制肿瘤血管新生、延缓肿瘤的侵袭与迁移、缓解肿瘤细胞的多药耐药性等发挥作用。现对近年来开展的扶正补益类方药抗肝癌的机制研究进行综述,希望为肝癌的中西医结合治疗提供参考和新的思路。Primary liver cancer(PLC)is currently the fourth common malignant tumor and the second leading cause of tumor death in China.Western medical therapies for liver cancer include surgical resection,transplantation,hepatic artery chemoembolization,intratumor injection with anhydrous alcohol,and radiofrequency ablation.However,since advanced liver cancer is often accompanied by vascular invasion or even distant metastasis,the therapies above are not applicable.Choosing appropriate and effective systemic therapies can prolong the survival and improve the quality of life of advanced patients.According to the theory of traditional Chinese medicine(TCM),the occurrence of PLC is the rooted in the deficiency of healthy qi and triggered by the invasion of cancer toxin.TCM treatment can regulate the liver cancer microenvironment in a multi-target,multi-link,and multi-pathway manner.The healthy qi-reinforcing and tonifying prescriptions are capable of improving the quality of life,prolonging the survival,improving therapeutic effects,and reducing recurrence and metastasis.They can improve body functions by regulating the intestinal flora,the immune function,the signaling pathways and apoptosis of liver cancer cells,and the expression of oncogenes and tumor suppressor genes.This article reviews the studies about the mechanism of healthy qi-reinforcing and tonifying prescriptions in treating liver cancer in recent years,hoping to provide new ideas for the treatment of liver cancer with integrated traditional Chinese and western medicine.

关 键 词：扶正 本虚标实 补益 中药 原发性肝癌 免疫功能 中西医治疗 机制研究 

分 类 号：R285[医药卫生—中药学] R273[医药卫生—中医学]