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从中医病机探析肺癌肿瘤微环境

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肺癌是当今世界发病率和死亡率一直居高不下的恶性肿瘤,严重威胁着人民的生命健康.现代医学对肺癌的治疗基本经历了 3场变革——传统的放化疗、精准靶向治疗、免疫治疗.其中免疫治疗主要通过适应性免疫系统来监视并杀伤肿瘤细胞,当下热门的嵌合抗原受体T细胞免疫疗法正是通过增强T细胞靶向杀伤肿瘤细胞的能力,达到抗癌的目的.而免疫细胞是肿瘤微环境(TME)的一部分,可见,干预TME已然成为攻克癌症的着眼点.根据中医取类比象思维推测肺癌TME,并将其病机归纳为:免疫逃逸类似营卫失和、肺卫不固;缺氧微环境类似肺脾肾气虚;酸性微环境类似痰湿阻肺;炎性微环境类似痰瘀癌毒积聚.提示以肺癌TME与中医病机契合点为指导,为中医药治疗肺癌提供遣方用药的参考依据.
Tumor Microenvironment of Lung Cancer from the Pathogenesis of Traditional Chinese Medicine
Lung cancer is a malignant tumor with persistently high incidence and mortality rates worldwide,posing a serious threat to people's lives and health.Modern medicine has undergone three major transformations in the treatment of lung cancer,i.e.,tra-ditional chemotherapy and radiotherapy,precision targeted therapy,and immunotherapy.Among them,immunotherapy mainly relies on the adaptive immune system to monitor and kill tumor cells.The currently popular chimeric antigen receptor T cell immunothera-py enhances the ability of T cells to target and kill tumor cells,achieving the goal of anticancer treatment.Immunocytes are part of the tumor microenvironment(TME),indicating that intervening in the TME has become a focus of cancer treatment.TME can be speculated based on analogies from traditional Chinese medicine(TCM),and its pathogenesis is summarized as follows:immune e-vasion is similar to the disharmony between nutrient and defensive qi and insecurity of lung-defensive qi;hypoxic microenvironment is similar to qi deficiency of lung,spleen,and kidney;acidic microenvironment is similar to phlegm-dampness obstructing the lungs;inflammatory microenvironment is similar to accumulation of phlegm,blood stasis,and cancer toxin.It suggests that by alig-ning lung cancer TME with TCM pathogenesis,this study can provide a reference for the selection of TCM treatment for lung cancer.

Lung cancerImmune evasionAcidic microenvironmentInflammatory microenvironmentPathogenesis of TCMDisharmony between nutrient and defensive qiQi deficiency of lung,spleen,and kidneyAccumulation of phlegm,blood stasis,and cancer toxin

梁帅、尹怡、王俊涛、蒋立峰、龙云凯、任振杰、骆文龙、王祥麒

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河南中医药大学,郑州,450046

河南中医药大学第三附属医院,郑州,450008

河南省肿瘤医院,郑州,450003

肺癌 免疫逃逸 酸性微环境 炎性微环境 中医病机 营卫失和 肺脾肾气虚 痰瘀癌毒积聚

国家自然科学基金项目河南省中医药科学研究专项

U17041812022ZYZD13

2024

10.3969/j.issn.1673-7202.2024.03.020

世界中医药
世界中医药学会联合会

世界中医药

CSTPCDCHSSCD北大核心
影响因子：1.266
ISSN：1673-7202
年,卷(期)：2024.19(3)
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