论肿瘤微环境“营卫不和”的病机实质  

Pathological Nature of Disharmony between Nutrient Qi and Defensive Qi in Tumor Microenvironment

作　　者：文进渝 何佳玮 马琼 赖恒周 肖冲[1,2] 任益锋 由凤鸣[1,3] 付西 Wen Jinyu;He Jiawei;Ma Qiong;Lai Hengzhou;Xiao Chong;Ren Yifeng;You Fengming;Fu Xi(Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu,610072,China;Department of Oncology,Chengdu University of Traditional Chinese Medicine,Chengdu,610075,China;Cancer Institute,Chengdu University of Traditional Chinese Medicine,Chengdu,610075,China)

机构地区：[1]成都中医药大学附属医院,四川成都610072 [2]成都中医药大学肿瘤学教研室,四川成都610075 [3]成都中医药大学肿瘤研究所,四川成都610075

出　　处：《成都中医药大学学报》2025年第2期40-44,共5页Journal of Chengdu University of Traditional Chinese Medicine

基　　金：国家自然科学基金面上项目(82074315)。

摘　　要：代谢重编程介导肿瘤微环境免疫抑制是导致肿瘤免疫逃逸的关键因素。代谢免疫互作作为机体稳态调节的核心机制,与中医营卫学说有关理论认识相契合。营卫不和是人体免疫效应与代谢功能互作稳态失衡的关键。因此本文从“营卫不和”视角探析肿瘤微环境形成的机制,认为营卫不和的实质在于营壅卫遏、营虚卫滞、营瘀卫闭,扰乱代谢免疫互作节律,进而酿生痰、瘀、毒等病理因素并相互搏结,日久蕴积而致肿瘤微环境形成。笔者进一步提出营壅卫遏当疏通营卫、升清降浊,营虚卫郁当调营解卫、宣畅气机,营瘀卫闭当调和血气、通行血脉等调和营卫以重塑肿瘤微环境的治则,以期为肿瘤的中医药防治体系提供新的思路。Immunosuppressive tumor microenvironment induced by metabolic reprogramming of tumor cells is a crucial cause of immune escape from malignancies.Metabolic-immune interaction is the core mechanism of the body′s steady-state regulation,which is consistent with TCM theories of nutritional Qi and defensive Qi.The disharmony between nutrient Qi and defensive Qi is the key to the imbalance of homeostasis between the body′s immune effects and metabolic function interactions.This paper probes into the formation mechanism of tumor microenvironment from the theory of nutrient Qi and defensive Qi,and holds that the essence of the disharmony between nutrient Qi and defensive Qi lies in the stagnation of nutrient Qi and the suppression of defensive Qi,the deficiency of nutrient Qi and the stagnation of defensive Qi,and the stasis of nutrient Qi and the closing of defensive Qi,disturbing the metabolic-immune interaction rhythm,which will cause Phlegm,Blood stasis,Toxin and other pathological factors and struggle with each other,promoting the formation of tumor microenvironment while accumulation over time.In order to remodel the tumor microenvironment,it is further proposed to dredge the nutrient Qi and the defensive Qi and ascend clarity and descend turbidity when the nutrient Qi stagnated and the defensive Qi suppressed,to adjust the nutrient Qi and the defensive Qi and promote the Qi when it is in deficiency of nutrient Qi and the stagnation of defensive Qi,and to harmonize the Blood and the Qi and dredge the blood vessels when with the stasis of nutrient Qi and the closing of defensive Qi.We attempt to provide new insights for the prevention and treatment of tumor.

关 键 词：肿瘤微环境 营卫不和 代谢免疫互作 气血津液 病机实质 

分 类 号：R241.8[医药卫生—中医诊断学] R273[医药卫生—中医临床基础] R228[医药卫生—中医学]