从免疫编辑角度探讨恶性肿瘤“虚-毒”互作病机及其辨治  

Discussion on the pathogenesis of‘deficiency-toxicity’interaction of malignant tumors and differentiation and treatment from the perspective of immunoediting

作　　者：匡子禹 闫宁哲 刘可心 李杰[1] KUANG Ziyu;YAN Ningzhe;LIU Kexin;LI Jie(Guang’anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Beijing University of Chinese Medicine,Beijing 100029,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]北京中医药大学,北京100029

出　　处：《中华中医药杂志》2024年第12期6404-6408,共5页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：国家中医药传承创新团队项目(No.ZYYCXTD-C-202205);国家自然科学基金面上项目(No.82274608);中央高水平中医医院临床研究和成果转化能力提升项目(No.HLCMHPP2023001)。

摘　　要：文章基于“五期演变”理论,从免疫编辑视角探讨恶性肿瘤病机“虚-毒”互作的生物学基础,即“气虚不固”重在免疫清除减弱,“阳虚毒结”与免疫重塑增加相关,“癌毒流注”表现为肿瘤微环境诱导的癌细胞干性化特征,同时癌毒进一步戕害正气,“虚-毒”互作,致使毒盛正损;基于上述演变规律,结合团队“扶正五法”,笔者总结提出益气扶正增益免疫清除调控“虚”;益气温阳抑制免疫重塑截断“寒”;解毒扶正逆转肿瘤细胞干性抑制“毒”的诊疗思路;分源论治,锚定免疫编辑中医药干预的优势阶段,辨证用药与精准靶药相结合,并佐证以效验方剂,以期为临床提供一定的参考。Based on the theory of‘five-stage evolution’,this paper explores the biological basis of the interaction between‘deficiency-toxicity’in the pathogenesis of malignant tumors from the perspective of immunoediting,that is,‘qi deficiency and insolidity’focuses on the weakening of immune clearance,‘yang deficiency and poison nodules’are associated with increased immune remodeling,and‘cancer toxicity infusion’is manifested as the stemness of cancer cells induced by tumor microenvironment,and cancer toxicity further harms the healthy qi,and the‘deficiency-toxicity’interaction leads to the positive loss of toxicity.In summary,combined with the‘five methods of strengthening vita qi’put forward by our team,the author summarizes and proposes the diagnosis and treatment ideas of invigorating qi and strengthening and gaining immune clearance and regulation of‘deficiency’,inhibiting immune remodeling and truncating‘cold’by inhibiting temperature and yang,detoxifying and reversing the stemness inhibition of tumor cells,and anchoring the dominant stage of immune editing traditional Chinese medicine intervention,combining syndrome differentiation drugs with precise target drugs,and corroborating evidence to test prescriptions,in order to provide a certain reference for clinical practice.

关 键 词：免疫编辑 “虚-毒”互作 恶性肿瘤 五期演变 扶正五法 病因病机 辨治 

分 类 号：R73[医药卫生—肿瘤]