从“虚、毒、瘀”浅谈原发性肝癌病机和治疗

Discussion on pathogenesis and treatment of primary liver cancer from the perspective of“deficiency,poison,and blood stasis”

原发性肝癌(PLC)是我国常见的恶性肿瘤,预后极差,中医学认为虚毒瘀致病是阐释PLC发生、发展的重要理论,机体正气亏耗、外邪入侵所致气血阴阳失调,脏腑代谢等功能失常,痰浊、瘀血、癌毒内生结聚肝内形成肿块而发本病。现代医学则认为免疫微环境是正气亏虚的延伸,且炎症微环境、肿瘤外泌体、肠道菌群紊乱均为癌毒重要来源,现从“病机观”及“治疗观”出发,在阐述肝癌病机的同时对其治疗进行深度剖析,探讨瘀、毒、虚在原发性肝癌中的致病机制及以攻补兼施、扶正祛邪为纲的治法治则,提高临床思辨能力,为中医治疗肝癌,改善肝癌患者临床症状,提高其生活质量提供新的思路。

Primary liver cancer(PLC)is a common malignant tumor in China,with extremely poor prognosis.Traditional Chinese medicine believes that the pathogenesis of deficiency,toxin,and stasis is an important theory to explain the occurrence and development of PLC.It is mainly related to the depletion of vital energy in the body,the imbalance of qi,blood,yin,and yang caused by the invasion of external pathogens,dysfunction of viscera metabolism,and the formation of tumors in the liver caused by phlegm,blood stasis,and cancer toxin.Modern medicine believes that the immune microenvironment is an extension of the deficiency of vital energy,and that the inflammatory microenvironment,tumor secretions,and advocacy of bacterial flora disorders are important sources of cancer toxins.Starting from the“pathogenesis view”and the“treatment view”,this article elaborates on the pathogenesis of liver cancer while conducting a deep analysis of its treatment,exploring the pathogenic mechanism of blood stasis,toxin,and deficiency in primary liver cancer and the treatment principles based on both attacking and reinforcing,and strengthening the body and eliminating pathogenic factors,improve clinical thinking ability,provide new ideas for treating liver cancer with traditional Chinese medicine,improve clinical symptoms of liver cancer patients,and improve their quality of life.