基于虚毒瘀理论探讨铁死亡在肝癌发展中的作用

Exploring the Role of Ferroptosis in the Development of Liver Cancer Based on the Theory of Deficiency and Stasis

摘要: 原发性肝癌为本虚标实之证，其核心病机可概括为“虚毒瘀”，以正虚为本，毒瘀二者互结于体内为标。因虚失养则致脏腑不固，邪毒可乘虚侵络，瘀阻气血；毒瘀互结后反耗正气，三者交织演化，故形成恶性循环。铁死亡是一种铁依赖性死亡程序，其发生与铁代谢紊乱、脂质过氧化物堆积以及抗氧化系统失衡等途径密切相关。而二者功能具有一定的相似性。铁死亡的产生过程是该理论的微观体现，所产生的铁代谢异常、脂质过氧化物的异常堆积与邪毒、瘀血所产生的过程相似。而在正虚上又可同抗氧化系统联系。因此，本文基于“虚毒瘀”理论，阐述该机制，并以扶正补虚、解毒化瘀为法，实现中医药可以多途径、多靶点调控铁死亡，对于肝癌的防治具有重要意义。

Abstract: Primary liver cancer is the evidence of deficiency and reality, and its core pathogenesis can be summarized as “deficiency and poison stasis”, which is based on positive and deficiency, and the two are combined with each other in the body. Due to the lack of nourishment, the viscera are not solid, and the evil poison can take advantage of the deficiency to invade the network, stasis and obstruct qi and blood; after the poison and stasis are combined, the positive qi is consumed, and the three are intertwined and evolved, so a vicious circle is formed. Ferroptosis is an iron-dependent death procedure that occurs in a pathway that is closely related to iron metabolism disorders, lipid peroxide accumulation, and imbalances in the antioxidant system. However, the functions of the two have certain similarities. The process of ferroptosis is a microscopic embodiment of this theory, and the abnormal iron metabolism and abnormal accumulation of lipid peroxides are similar to the processes produced by evil poison and blood stasis. In terms of positive and void, it can be linked to the antioxidant system. Therefore, based on the theory of “deficiency and poison stasis”, this paper expounds the mechanism, and realizes that traditional Chinese medicine can regulate ferroptosis in multiple ways and multiple targets by correcting and supplementing deficiencies and detoxify and dispel stasis, which is of great significance for the prevention and treatment of liver cancer.