中药抗肿瘤配伍结构应用探析  

Application of Anti-tumor Compatibility Structure of Chinese Medicine

作　　者：陈兰品 谭峰[1] 魏小曼 王俊壹 李柳[2,3,4] 吴勉华 程海波[2,3,4] 孙东东 CHEN Lanpin;TAN Feng;WEI Xiaoman;WANG Junyi;LI Liu;WU Mianhua;CHENG Haibo;SUN Dongdong(School of Clinical Medicine of Nanjing University of Chinese Medicine,Nanjing 210023,China;The First School of Clinical Medicine of Nanjing University of Chinese Medicine,Nanjing 210023,China;Jiangsu Collaborative Innovation Center of Traditional Chinese Medicine forTumor Prevention and Treatment,Nanjing 210023,China;The Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210029,China)

机构地区：[1]南京中医药大学中医学院,南京210023 [2]南京中医药大学第一临床医学院,南京210023 [3]江苏省中医药防治肿瘤协同创新中心,南京210023 [4]南京中医药大学附属医院,南京210029

出　　处：《中国实验方剂学杂志》2025年第8期198-208,共11页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金项目(82374287,82361168663);江苏省中医药科技发展计划重点项目(ZD202201);全国名老中医药专家传承工作室(国中医药人教函[2022]75号);国家中医药管理局第七批全国老中医药专家学术经验继承工作项目(国中医药人教函[2022]76号);第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]239号)。

摘　　要：恶性肿瘤是危害人类生命健康的重大疾病之一,中药在临床抗肿瘤治疗中具有独特的优势。然而如何在临床实践中实现中药的抗肿瘤作用到中药抗肿瘤疗效的转换,则是中医药治疗恶性肿瘤过程中必须解决的核心问题。与现代化学药物不同,中药配伍应用是决定抗肿瘤中药是否能发挥最佳药效,实现“增效减毒”的关键因素。在此基础上构建的方药配伍结构则是临床抗肿瘤中药安全、高效、合理运用的基本形式,其中主要包括药对、角药、复方配伍三类。药对“七情”配伍虽然具有结构简单、针对性强(增效减毒)的特点,但功效单一,不能完全兼顾肿瘤复杂的病机因而在实践中较少单独使用;角药配伍相较于药对拓宽了药物在临床治疗中的适用范围,但治疗范畴仍然有限;复方“君臣佐使”传统方剂配伍将药对、角药囊括其中,提高中药在重病、疑病、慢病、杂病的疗效,但因时代背景的局限其未与现代临床实践及现代药理研究成果结合,限制复方配伍理论的发展。随着现代医学技术的出现,其与传统中药配伍理论结合创立了现代创新配伍理论,其中包括与结合现代中药药理学产生的“援药”理论,弥补“君臣佐使”理论无法精准用药的缺陷;结合药理学及现代医学内容产生的“态靶辨治”理论,弥补了“君臣佐使”理论对疾病认知的不足。临床中药抗肿瘤在以上配伍形式及配伍理论的指导下,发挥出抗肿瘤中药的最大药效,对中药在临床肿瘤治疗运用中具有重大意义。Malignant tumors are one of the major diseases that endanger human life and health.Chinese medicine has unique advantages in clinical anti-tumor treatment.However,how to translate the anti-tumor effects of Chinese medicine into clinical practice is the core issue that must be addressed in the process of treating malignant tumors with traditional Chinese medicine(TCM).Unlike modern chemical drugs,the compatibility application of Chinese medicine is the key factor that determines whether Chinese medicine can achieve optimal anti-tumor efficacy and realize the goal of"enhancing efficacy and reducing toxicity".The formulation structure based on this compatibility is the basic form for the safe,efficient,and rational clinical use of anti-tumor Chinese medicine,and it mainly includes three categories:herb pairs,tri-herbal combinations,and compound compatibility.Although herb pairs have the characteristics of a simple structure and strong targeting(enhancing efficacy and reducing toxicity),they often have a single effect and cannot fully address the complex pathogenesis of tumors.As a result,herb pairs are rarely used alone in practice.Compared to herb pairs,tri-herbal combinations broaden the application scope of herbs in clinical treatment,but their therapeutic range remains limited.The traditional"sovereign,minister,assistant,and guide"compound prescription,which includes herb pairs and tri-herbal combinations,improves the efficacy of herbs in treating serious diseases,hypochondriasis,chronic diseases,and miscellaneous disorders.However,due to the limitations of its historical background,it has not been integrated with modern clinical practice and modern pharmacological research,which restricts the development of compound compatibility theory.With the emergence of modern medical technology,it has been combined with traditional compatibility theory of Chinese medicine to create an innovative modern compatibility theory.This includes the"aid medicine"theory derived from modern Chinese medicine pharmacology,which compen

关 键 词：抗肿瘤 中药配伍 对药 角药 态靶辨治 

分 类 号：R256[医药卫生—中医内科学] R273[医药卫生—中医学] R285.5