| 引用本文: |
齐同飞, 何兰, 唐迎港, 田道法, 何迎春.“透毒培元”视角下胞葬作用与局部晚期鼻咽癌化疗敏感性的中医辨治策略[J].湖南中医药大学学报,2025,45(11):2149-2157[点击复制] |
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| “透毒培元”视角下胞葬作用与局部晚期鼻咽癌化疗敏感性的中医辨治策略 |
| 齐同飞,何兰,唐迎港,田道法,何迎春 |
| (湖南中医药大学, 湖南 长沙 410208;湖南中医药大学第一附属医院, 湖南 长沙 410007;湖南省中医药防治眼耳鼻咽喉疾病与视功能保护工程技术研究中心, 湖南 长沙 410208) |
| 摘要: |
| 鼻咽癌（NPC）是具有显著地域聚集性的高度异质性上皮源性恶性肿瘤，超过70%的患者初诊即为局部晚期。中医学将其归属于“真头痛”“鼻渊”“恶核”等范畴，病机总属“毒瘀痰结、本虚标实”，辨证多属“热毒壅盛、气阴两虚”，提出“透毒培元”治则，以疏毒开闭、培本固正为核心纲领。胞葬作用是吞噬细胞清除凋亡细胞的过程。在肿瘤微环境中，过度胞葬可削弱抗原提呈，限制免疫激活，诱发耐药并促进免疫逃逸。局部晚期NPC虽以铂类药物同步放化疗为标准治疗方案，但目前仍面临化疗敏感性低、免疫逃逸及远期生存率不高等瓶颈，其关键病理环节正是肿瘤微环境中胞葬作用过度激活所致的免疫沉默。本文围绕“透毒培元”治则，结合胞葬作用，构建提升化疗敏感性的辨证路径，拓展中医药调控肿瘤免疫微环境的理论与干预维度，为中西医整合优化局部晚期NPC疗效提供新思路。 |
| 关键词: 胞葬作用 局部晚期鼻咽癌 铂类耐药 化疗敏感性 透毒培元 吞噬功能 免疫 |
| DOI：10.3969/j.issn.1674-070X.2025.11.017 |
| 投稿时间：2025-07-18 |
| 基金项目:国家自然科学基金项目(82305329); 湖南省自然科学基金项目(2023JJ30449); 长沙市自然科学基金项目(kq2208206); 湖南省教育厅项目(23A0298); 湖南省卫生健康高层次人才重大专项项目(R2023111)。 |
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| Efferocytosis and TCM pattern identification and treatment strategies for chemosensitivity in locally advanced nasopharyngeal carcinoma from the perspective of “expelling toxins and reinforcing yuan-primodial qi” |
| QI Tongfei, HE Lan, TANG Yinggang, TIAN Daofa, HE Yingchun |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China;Hunan Engineering Technology Research Center for Prevention & Treatment of Ophthalmology and Otolaryngology Diseases and Visual Function Protection with Chinese Medicine, Changsha, Hunan 410208, China) |
| Abstract: |
| Nasopharyngeal carcinoma（NPC） is a highly heterogeneous epithelial-derived malignant tumor with significant geographical aggregation, over 70% of patients with locally advanced disease at initial diagnosis. In TCM, it is classified under categories such as "true headache", "nasal sinusitis", and "malignant tumor mass". The pathogenesis is generally attributed to "coagulation of toxin, blood stasis, and phlegm, with deficiency root and excess manifestation," while its pattern identification often involves "heat-toxin accumulation and deficiency of both qi and yin." The therapeutic principle of "expelling toxins and reinforcing yuan-primodial qi" is proposed, with the core tenets being to dispel toxins, unblock obstructions, and strengthen the foundation to consolidate healthy qi. Efferocytosis is the process by which phagocytic cells clear apoptotic cells. In the tumor microenvironment,excessive efferocytosis can impair antigen presentation, limit immune activation, induce drug resistance, and promote immune evasion. Although concurrent chemoradiotherapy with platinum-based drugs remains the standard treatment for locally advanced NPC, challenges such as low chemosensitivity, immune evasion, and poor long-term survival rates still persist. The critical pathological link lies in immune silence caused by overactivation of efferocytosis in the tomor microenvironment. This paper focuses on the therapeutic principle of "expelling toxins and reinforcing yuan-primodial qi", integrating the efferocytosis to construct a pattern identification pathway that enhances chemosensitivity. It expands the theoretical and interventional dimensions of TCM in regulating the tumor immune microenvironment, providing novel insights for integrating Chinese and western medicine to optimize treatment outcomes for locally advanced NPC. |
| Key words: efferocytosis nasopharyngeal carcinoma platinum resistance chemosensitivity expelling toxins and reinforcing yuan-primodial qi phagocytic function immune |
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