1.上海中医药大学附属岳阳中西医结合医院,上海市虹口区甘河路110号,200437
2.上海交通大学医学院附属胸科医院肺部肿瘤临床医学中心
3.复旦大学附属肿瘤医院
通信作者:xulq67h@163. com
收稿:2025-06-29,
修回:2025-08-25,
纸质出版:2025-12-02
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邵世梁,牛晓敏,章瑶等.基于“毒聚伤阴”探讨恶性肿瘤转移前生态位的病机演变与辨治策略[J].中医杂志,2025,66(23):2426-2432.
SHAO Shiliang,NIU Xiaomin,ZHANG Yao,et al.Pathogenesis,Differentiation and Treatment of Pre-Metastatic Niche in Malignant Tumors Based on the Theory of "Toxin Accumulation Damaging Yin"[J].Journal of Traditional Chinese Medicine,2025,66(23):2426-2432.
邵世梁,牛晓敏,章瑶等.基于“毒聚伤阴”探讨恶性肿瘤转移前生态位的病机演变与辨治策略[J].中医杂志,2025,66(23):2426-2432. DOI: 10.13288/j.11-2166/r.2025.23.006.
SHAO Shiliang,NIU Xiaomin,ZHANG Yao,et al.Pathogenesis,Differentiation and Treatment of Pre-Metastatic Niche in Malignant Tumors Based on the Theory of "Toxin Accumulation Damaging Yin"[J].Journal of Traditional Chinese Medicine,2025,66(23):2426-2432. DOI: 10.13288/j.11-2166/r.2025.23.006.
基于“毒聚伤阴”理论认为,恶性肿瘤转移前生态位(PMN)的病理产物蓄积与内稳态破坏分别对应于“毒聚”和“伤阴”。PMN动态病机演变过程中,始动期主要病机为正虚痰壅、痹阻营卫,治宜健脾温阳、扶正固本、佐以化痰;进展期主要病机为痰瘀互结、络损生变,治疗当化痰消瘀、虫类药攻积、截断传变;终末期主要病机为痰瘀化火、气阴耗伤,治疗需益气养阴、清补兼施、制火解毒。PMN形成之后,邪毒可循络流注,趋近于功能失调、虚实偏颇之相应脏腑形成恶性肿瘤。从“毒聚伤阴”理论认识恶性肿瘤PMN的中医病机演变理论框架,可为中医药防治恶性肿瘤转移提供思路。
According to the theory of "toxin accumulation damaging
yin
", the accumulation of pathological products and the disruption of homeostasis in the pre-metastatic niche (PMN) of malignant tumors correspond to "toxin accumulation" and "
yin
damage" respectively. During the dynamic evolution of PMN, the main pathogenesis in the initial stage is healthy
qi
deficiency and phlegm congestion, obstruction in the
ying
(营)
and
wei
(卫) level, for which the therapeutic approach is fortifying spleen and warming
yang
, reinforcing healthy
qi
, consolidating the root, and assissting in resolving phlegm. In the progression stage, the predominant mechanism is mutual binding of phlegm and stasis, with collateral damage and pathological transformation. Treatment should focus on resolving phlegm and eliminating stasis, using insect-derived medicinals to attack accumulation and block pathological transmission. In the terminal stage, the main pathogenesis involves phlegm-stasis transforming into fire, with depletion of
qi
and
yin
, for which it is suggested to replenish
qi
and nourish
yin
, combine clearing and tonifying methods to control fire-toxin. After the PMN has formed, pathogenic toxin may flow along the collaterals, tending to lodge in corresponding viscera with functional imbalance and deviation between deficiency and excess, eventually giving rise to malignant tumors. Understanding the pathogenesis of the PMN in the malignant tumors based on the "toxin accumulation damaging
yin
" theory may provide a valuable perspective for developing traditional Chinese medicine strategies for the prevention and treatment of tumor metastasis.
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