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基于对癌因性疲乏（CRF）现代医学病理机制与中医学病机的分析，提出下丘脑-垂体-肾上腺轴（HPA轴）功能紊乱是CRF的重要病理机制，而HPA轴异常与中医肾、脾、肝三脏功能失调密切相关。肾阳虚损可致HPA轴功能抑制，进而致皮质醇分泌异常；脾虚气弱可致HPA轴负反馈调节机制紊乱，加剧能量代谢障碍；肝郁气滞则易引发HPA轴过度激活，形成慢性应激负荷。据此，提出“温肾益气以振先天元气，健脾升阳以充后天气血，疏肝调神以调气机情志”的CRF中医干预策略，为临床防治CRF提供思路。
Abstract：This paper analyzed the pathogenesis of cancer-related fatigue(CRF) in traditional Chinese medicine(TCM) and the pathological mechanism of hypothalamic-pituitary-adrenal(HPA) axis dysfunction. It is hypothesized that the abnormality of the HPA axis is closely associated with the dysfunction of the kidney, spleen, and liver in TCM, playing an important role in the onset and progression of CRF. Specifically, kidney yang depletion can inhibit the function of the HPA axis, thereby leading to abnormal cortisol secretion. Spleen deficiency and qi weakness can disrupt the negative feedback regulation mechanism of the HPA axis, exacerbating energy metabolism disorders and endocrine homeostasis imbalance. Liver constraint and qi stagnation can readily cause excessive activation of the HPA axis and give rise to chronic stress load. Based on this, a TCM intervention strategy of "warming the kidney and supplementing qi to stimulate the congenital original qi, fortifying the spleen and promoting yang to replenish the postnatal qi and blood, and soothing the liver and regulating the spirit to regulate the qi movement and emotion" is proposed, offering a clinical approach for the prevention and treatment of CRF.
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基本信息:
DOI：10.13288/j.11-2166/r.2026.08.005
中图分类号:R273
引用信息:
[1]钟毅薇,谭滢,王灿霖,等.基于下丘脑-垂体-肾上腺轴探析癌因性疲乏的病机及干预策略[J].中医杂志,2026,67(08):833-837.DOI:10.13288/j.11-2166/r.2026.08.005.
基金信息:
北京市自然科学基金（7252261）; 中国中医科学院优秀青年科技人才（创新类）培养专项（ZZ14-YQ-013）; 中国中医科学院广安门医院科研基金（2023031,2024009）
2026-04-16
2026-04-16