基于“态靶辨证”和肝脏病机要素探讨肿瘤肝转移的防治内涵

Prevention and treatment implications of tumor liver metastasis based on state-target strategy and pathogenesis elements of liver

态靶辨证是由仝小林院士提出的临床辨治模式,通过结合宏观辨证与微观辨证,建立全程、动态、连续的疾病认识,并指导中医药的精准化治疗。肿瘤肝转移的生物学过程十分复杂,目前缺乏对其动态的病机变化认识。总结肿瘤肝转移的动态变化病机为郁→虚→瘀→积→损,通过宏观认识肝转移初始期、前期、中期、末期的“态”,提出以养血调肝为核心的扶正调态手段。在肿瘤肝转移的现代医学研究基础上,提出中药(如消癌解毒药、活血消癥药、行气化痰散结药等)微观靶向性治疗,形成全方位的态靶结合肿瘤肝转移防治策略,对中医药精准化防治肝转移具有一定的指导意义。

The state-target strategy is a clinical differentiation and treatment pattern proposed by Academician Tong Xiaolin.It guides the precise treatment of traditional Chinese medicine by combining macroscopic and microscopic syndrome differentiation to establish a comprehensive,dynamic,and continuous understanding of diseases.The biological process of tumor liver metastasis is very complex,and currently there is a lack of dynamic understanding of its pathogenesis.Under the guidance of the theory of‘state-target’strategy,we summarized the dynamic changes in the pathogenesis of liver metastasis as depression,deficiency,stagnation,accumulation,and damage,recognized the state of liver metastasis at the initial,early,intermediate,and final stages macroscopically,and proposed the method of nourishing blood and regulating liver as the core means to supplement the healthy qi and regulate the state.Based on modern medical research on tumor liver metastasis,we proposed the micro-targeted therapy with traditional Chinese medicine(such as Chinese medicinal materials for eliminating cancer and removing toxicity,activating blood and dissipating mass,and regulating qi and resolving phlegm),forming a comprehensive state-target strategy for the prevention and treatment of tumor liver metastasis.It has certain guiding significance for the precise prevention and treatment of liver metastasis with traditional Chinese medicine.