摘要
胆道恶性肿瘤是来源于胆囊及胆管上皮的一组高度异质性的恶性肿瘤,包括胆囊癌及胆管癌,恶性程度高,确诊时往往病程已至中晚期,预后差。中晚期胆道恶性肿瘤治疗难度大,缺乏统一的化疗标准及具有针对性的靶向药物,临床综合治疗一直处于瓶颈状态。中药复方具有多靶点、多环节、多途径特点,可以发挥稳定肿瘤,缓解临床症状,减轻放化疗毒副作用,提高生存质量等优势,尤其在晚期肿瘤患者对症治疗中有着不可替代的作用,因而受到诸多科研工作者关注。中医认为晚期胆道恶性肿瘤病机多属正虚邪盛、阴阳乖戾、寒热错杂,病位涉及肝胆脾胃肾,其在病位、病程及病证上与厥阴病表现相似,故临床应用乌梅丸治疗常获佳效。乌梅丸从中医"理、法、方、药"角度分析,具有寒热并调,清上温下,温肝扶阳,攻补兼施等功效,兼顾肝、脾、肾,符合晚期胆道恶性肿瘤的中医证候学特点;从现代中药药理学角度分析,乌梅丸中多种有效成分具有诱导肿瘤细胞凋亡、抑制肿瘤细胞增殖、减轻机体炎症反应、抑制血管生成、逆转肿瘤细胞多药耐药性以及调节机体免疫力等作用。该文通过从中西医角度分析乌梅丸治疗晚期胆道恶性肿瘤的可行性,为晚期胆道恶性肿瘤的临床综合治疗及中药复方的实验研究提供参考。
Biliary tract cancers are group of highly heterogeneous malignant tumors derived from gallbladder and bile duct epithelium,including gallbladder cancer and cholangiocarcinoma,with a high degree of malignancy. When diagnosed,the course of disease often develops to the middle and late stage,with a poor prognosis. It is difficult to treat the advanced biliary tract cancers,with a lack of unified chemotherapy standard and targeted drugs. Traditional Chinese medicine(TCM)compound has multi-target,multi-link and multi-path characteristics, with effects in stabilizing tumor, alleviating clinical symptoms, alleviating side effect of radiotherapy and chemotherapy,and improving the quality of life. Especially in the treatment of advanced cancer patients,it plays an irreplaceable role. Therefore,it is concerned by many researchers. According to TCM,the pathogenesis of patients with advanced biliary tract cancers are mainly due to asthenia of healthy Qi and sthenia of pathogenic factors,Yin-Yang disharmony,and simultaneous occurrence of cold and heat. The location of the disease is related to liver,gallbladder,spleen,stomach and kidney. Because the advanced biliary tract cancers are similar to Jueyin syndrome in disease location,course and disease,Wumeiwan is often used in clinical treatment. Based on "theory, method, prescription and medicine" of TCM,Wumeiwan has the effect in regulating cold and heat,clearing the upper and lower temperature,warming the liver and supporting Yang,attacking and supplementing simultaneously,balancing the liver,spleen and kidney,which conforms to the TCM syndrome characteristics of advanced biliary tract cancers, according to modern Chinese medicine pharmacology,many effective ingredients in Wumeiwan have the effects in inducing tumor cell apoptosis,inhibiting tumor cell proliferation and reducing tumor cell proliferation,reducing inflammatory response in the body,inhibiting angiogenesis,reversing multidrug resistance of tumor cells and regulating immunity. This paper analyzes the feasibility of treatment of advanced biliary tract cancers with Wumeiwan from the perspective of traditional Chinese and Western medicine,so as to provide reference for clinical comprehensive treatment of advanced biliary tract cancers and the experimental study of TCM.
作者
夏霖
苏丽
张梅
XIA Lin;SU Li;ZHANG Mei(Graduate School,Anhui University of Chinese Medicine.Hefei 230038,China;The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)
出处
《中国实验方剂学杂志》
CAS
CSCD
北大核心
2021年第1期229-234,共6页
Chinese Journal of Experimental Traditional Medical Formulae
基金
国家自然科学基金面上项目(81774051)。
作者简介
第一作者:夏霖,在读硕士,从事中西医结合防治肿瘤的临床及基础研究,E-mail:1151488221@qq.com;通信作者:张梅,博士,主任医师,副教授,博士,导师,从事中西医结合防治肿瘤的临床及基础研究,E-mail:2239824941@qq.com。
