调气解毒理论视域下细胞程序性死亡对肿瘤免疫稳态的调节及中医药的干预作用  

Regulation of Tumor Immune Homeostasis by Programmed Cell Death and Intervention Effect of Traditional Chinese Medicine Under Theory of Regulating Qi and Resolving Toxins

作　　者：杨冰炜 陈雪 王成磊 翟浩宇 李卫东[1] 花宝金[1] YANG Bingwei;CHEN Xue;WANG Chenglei;ZHAI Haoyu;LI Weidong;HUA Baojin(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China;Graduate School,Shaanxi University of Chinese Medicine,Xianyang 712046,China)

机构地区：[1]中国中医科学院广安门医院,北京100053 [2]陕西中医药大学研究生院,陕西咸阳712046

出　　处：《中国实验方剂学杂志》2025年第7期212-220,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(82174464);国家中医药管理局中医药创新团队及人才支持计划项目(ZYYCXTD-C-202205);中国中医科学院科技创新工程项目(CI2021A01806,CI2021B009);中央高水平中医医院临床科研业务费资助项目(HLCMHPP2023085)。

摘　　要：肿瘤免疫稳态是机体在免疫系统的监视下,及时清除异常突变细胞以防止肿瘤发生发展,而不损伤其他正常细胞的动态平衡状态,是认识肿瘤发生发展过程的重要概念。细胞程序性死亡(PCD)是一种可调节性的细胞死亡,包含细胞凋亡、自噬、焦亡、坏死、铁死亡等多种形式,被视为机体清除异常或突变细胞的重要方式。近年来,现代研究发现PCD对肿瘤的发生发展具有双向调节作用,即在肿瘤前期生成阶段,PCD可通过发挥特异性免疫清除作用,及时控制肿瘤进展;在肿瘤后期成瘤阶段,PCD则可通过形成肿瘤特定微环境,促进肿瘤细胞的生长发展,产生致癌作用,因此PCD被视为维持肿瘤免疫稳态的重要途径。该团队在余桂清、朴炳奎教授“扶正培本”思想的基础上,提出“调气解毒”理论并应用于肿瘤临床防治。该研究基于“调气解毒”理论,总结目前现代医学对于PCD相关机制研究的进展,阐发PCD在肿瘤免疫稳态调节中的作用,认为气机调和状态是正常PCD维持肿瘤免疫稳态平衡的基础条件,气机失调、癌毒演化病机是PCD异常,肿瘤免疫稳态失衡,导致肿瘤细胞逃逸发展的核心过程。因此,在“调气解毒”理论指导下,总结性提出肿瘤全周期防治思路,肿瘤生成前期运用“调气扶正”之法以重塑肿瘤免疫稳态,促进异常细胞清除;肿瘤形成后期运用“解毒散邪”之法以逆转肿瘤特定微环境,抑制肿瘤细胞发展,以期为中医药防治肿瘤提供新的理论支持。Tumor immune homeostasis is a dynamic equilibrium state in which the body removes abnormal mutated cells in time to prevent tumor development without damaging other normal cells under the surveillance of the immune system.It is an important concept to understand the process of tumor development.Programmed cell death(PCD)is a kind of regulable cell death including various forms such as apoptosis,autophagy,pyroptosis,necrosis,and ferroptosis.It is regarded as an important way for the body to remove abnormal or mutated cells.In recent years,modern research has found that PCD has a bi-directional regulatory effect on carcinogenesis and tumor development.In the early stage of tumor formation,PCD can control tumor development in time by playing a specific immune clearance role,while in the later tumorigenic stage,PCD can promote the growth and development of tumor cells by forming a tumor-specific microenvironment,resulting in carcinogenic effects.Therefore,PCD is regarded as an important way to maintain tumor immune homeostasis.Based on the idea of"supporting the vital Qi and cultivating the root"by professors Yu Guiqing and Piao Bingkui,the team proposed the theory of"regulating Qi and resolving toxins"and applied it to clinical tumor prevention and treatment.Based on the theory of"regulating Qi and resolving toxins",the research summarized the current progress of modern medical research on mechanisms related to PCD to explore the role of PCD in the regulation of tumor immune homeostasis.The article believed that the harmonious state of Qi movement was the basic condition for normal PCD to maintain tumor immune homeostasis,while the disorder of Qi movement and the evolution of tumor toxicity were the core processes of abnormal PCD and disorder of tumor immunity homeostasis,which led to the escape and development of tumor cells.Therefore,under the guidance of"regulating Qi and removing toxins",the idea of full-cycle prevention and treatment of tumors was proposed summarily.In the early stage of tumor formation,the met

关 键 词：调气解毒 细胞程序性死亡 肿瘤免疫 稳态调节 中医药 

分 类 号：R2-031[医药卫生—中西医结合] R287[医药卫生—中医学] R285.5