中医药强化大剂量维生素C治疗肿瘤作用

Traditional Chinese medicine enhances the role of high-dose vitamin C in treating tumors

肿瘤大剂量维生素C(HVC)治疗本质上是一种代谢调节,通过促氧化应激、表观遗传修饰、免疫和氧感应调控等机制调节肿瘤和机体代谢重编程而治疗肿瘤。中医药具有多靶点、多途径调控机体和肿瘤复杂代谢网络的天然优势,通过辨证论治和“态-靶”辨治,能实现机体、肿瘤间的时空协同调控。研究表明,肿瘤“虚、毒、瘀”原创病机可类比肿瘤能量流、物质流和输泄流代谢障碍,HVC治疗同时干预了肿瘤“虚、毒、瘀”病机,而抗肿瘤清热解毒、活血化瘀和扶正固本药物又分别对肿瘤线粒体代谢、脂质代谢和氨基酸代谢具有调控作用,中医药可以从促氧化应激、诱导铁死亡、线粒体呼吸抑制等多个角度强化HVC治疗肿瘤效果。本文基于肿瘤“虚、毒、瘀”代谢重编程和“态-靶”辨治理论,诠释中医药强化HVC治疗理论依据,凝练中药强化HVC治疗可能的靶点和协同治疗方案,为中药联合HVC治疗肿瘤提供新的思路。

High-dose vitamin C(HVC)therapy for tumors is esentially a metabolie modulation that treats tunors by regulating tumor and body metabolic reprogramming through mechanisms such as pro-oxidative stress,epigenetic modifcations,immune and oxygen-sensing modulation.Traditional Chinese medicine(TCM)has the natural advantage of multi-target and multi-path to regulate the complex metabolic network of the body and tumor.Through treatment based on patterm diferentiation and"state-target"treatment,it can realize the spatial and temporal synergistic regulation between the body and tumor.Research shows that the original pathogenesis of tumor"deficiency,toxicity and stasis"can be analogous to the metabolic disoders of tumor energy flow,material flow and drainage flow,and HVC treatment for tumor intefere with the pathogenesis of tumor"deficiency,toxieity and stasis"at the same time.The anti-tumor Heat-clearing and Detoxifying,Blood-activaing and Susis-eliminating,and the Body resistance-strengthening and consolidating drug have regulatory effects on tumor mitochondrial metabolism,lipid metabolism and amino acid metabolism respectively,and TCM can strengthen the effect of HVC for tumor treatment from multiple perspectives such as pro-oxidative stress,induction of ferroptosis,and inhibition of mitochondrial respiration.Based on the theory of the metabolie reprogramming of tumor deficiency,toxicity and stasis"and"state-target"treatment based on patterm diferentiation,this paper interprets the theoretical basis of HVC treatment fortified with TCM for tumors,and condenses the possible targets and synergistic treatment protocols of HVC treatment fortifed with TCM for tumors,providing new ideas for TCM combined with HVC treatment for tumors.