基于肿瘤微环境讨论化湿解毒法诊治胃癌相关研究进展

文章信息/Info

• Title:基于肿瘤微环境讨论化湿解毒法诊治胃癌相关研究进展

• 卷期:2023年21卷24期

• 作者:毛旺楠1 裘生梁2 庞西1 贺雨婷1

• 1.浙江中医药大学第一临床医学院,浙江 杭州 310053；2.浙江省中医院，浙江 杭州 310006

• Author(s):MAO Wangnan1, Qiu Shengliang 2 ,Pang Xi1, He Yuting1

• 1. The First Clinical Medical College, Zhejiang Traditional Chinese Medicine University, Zhejiang Province, Hangzhou 310053, China; 2. Zhejiang Provincial Hospital of Traditional Chinese Medicine, Zhejiang Province, Hangzhou 310006, China)

• 关键词化湿解毒；肿瘤微环境；胃癌

• Keywords:Huashi Jiedu;tumor microenvironment; gastric cancer

• 摘要:随社会经济发展和饮食结构改变，胃癌逐渐成为世界范围内消化道第三大恶性肿瘤[1]。肿瘤微环境（Tumor Micro-environment, TME）是肿瘤细胞及其分泌、招募成分形成具有抑制局部炎症反应，促进微血管生成，增强淋巴管通透性及细胞亲器官性的转移前准备环境，已被证实可通过多靶点、多途径促进胃癌进展并逆转其耐药[2]。中医药辨证论治胃癌患者临床经验概括其病机多为“本虚标实”，“本虚”即脾胃正气亏虚，“标实”即脾虚湿盛、酝生癌毒，笔者将就中医药通过肿瘤微环境干预调节胃癌，发挥低毒高效等优势进行阐述，以供同道探讨。                                                                                                                                                                                

• Abstract: With the development of society and economy and the change of diet structure, gastric cancer has gradually become the third leading cause of cancer-related death [1]. Tumor micro-environment (TME) is a pre-metastasis preparation environment for Tumor cells and their secreting and recruiting components to inhibit local inflammatory response, promote microangiogenesis, enhance lymphatic permeability and organophilia, and thus achieve gene reprogramming, cell proliferation, invasion and metastasis. It has been proved to promote the progression of gastric cancer and reverse its drug resistance through multi-target and multi-pathway [2]. The clinical experience of treating gastric cancer patients based on syndrome differentiation of traditional Chinese medicine summarizes the pathogenesis of gastric cancer patients as follows: "Benxu Biaoshi, what is characterized by the lack of vital qi and excessive dampness of spleen and toxin of cancer". The author will explain the advantages of TCM in regulating gastric cancer through tumor microenvironment intervention and exerting low toxicity and high efficiency, for the discussion of his colleagues.

  胃癌的分期与诊断依托于西医的影像检查、实验室诊断以及各项病理指标，且离不开放化疗手术，而中医可于宏观层面对人体内环境进行调节，中多分子多途径改善胃癌微环境，拥有减毒增效，抑瘤杀瘤、强健体魄、改善预后等诸多优势。胃癌在古籍中并无明文记载，《医宗必读》云：“积之成也，正气不足，而后邪气居之”，从中医基础理论出发，胃癌是湿毒郁结，伤及脾胃元气所生病理产物，脾胃位于中焦，肿瘤既成，湿毒内蕴，阻碍脾胃二者的气机升降，形成脾气不得升，胃气不得降，失其代偿，脏腑不安的人体环境。