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肝癌免疫抑制性肿瘤微环境是促进原发性肝癌进展的重要因素，调控肝癌免疫抑制性肿瘤微环境是当前肝癌治疗的研究热点。提出痰瘀是肝癌免疫抑制性肿瘤微环境形成的物质基础；痰瘀互结不断演进，导致气闭、浊邪、络亢、火毒、正虚等因素产生并相互作用，共同构成复杂的肝癌免疫抑制性肿瘤微环境。基于痰瘀病机拟定化痰祛瘀方以改善肝癌免疫抑制性肿瘤微环境，并在临床运用时根据分型、分期以及全身治疗等因素加减，发挥中医学整体观念的优势，以实现肝癌的综合治疗。
Abstract：ABSTRCT Immunosuppressive tumor microenvironment(ITME) of liver cancer is a critical factor driving the malignant progression of primary liver cancer. Regulating ITME of liver cancer has become a focal point in current research on liver cancer therapy. This article proposed that phlegm and blood stasis constitute the material basis for the formation of ITME in liver cancer. The interaction and continuous evolution of phlegm and blood stasis lead to the generation and interplay of pathological factors such as qi block, turbid pathogen, collateral hyperactivity, fire toxin, and healthy qi deficiency, which constitute the complex ITME of liver cancer. The formulas for dissolving phlegm and dispelling blood stasis are formulated based on the pathomechanism of phlegm and blood stasis to improve ITME of liver cancer. In clinical practice, taking the factors such as syndrome type, disease stage, and systematic treatment into consideration, with reference of traditional Chinese medicine(TCM) and western medicine, the formu-las are adjusted based on pattern differentiation, so that the holism concept of TCM can be leveraged to achieve compre-hensive treatment for liver cancer.
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基本信息:
DOI：10.13288/j.11-2166/r.2025.14.007
中图分类号:R273
引用信息:
[1]张一鸣,王子健,田辛晨等.肝癌免疫抑制性肿瘤微环境的痰瘀病机与治疗策略[J].中医杂志,2025,66(14):1444-1449.DOI:10.13288/j.11-2166/r.2025.14.007.
基金信息:
国家自然科学基金（82074360）; 山东省泰山学者青年专家项目（tsqn201909200）; 国家中医药管理局科技司共建科技项目（GZY-KJS-SD-2023-026）; 济宁市重点研发项目（2023YXNS234）