基于“一气周流，四象脾土”理论论治非小细胞肺癌

Treatment of Non-Small-Cell Lung Cancer Based on the Theory of “One Qi Circulating Endlessly, Four Emblems of Spleen-Earth”

摘要: 非小细胞肺癌(NSCLC)是现代肿瘤学治疗的难点，中医药通过整体调节展现独特优势。本文以黄元御“一气周流，四象脾土”理论为核心，探讨NSCLC的病机演变与治疗策略。认为中气衰败、脾土不运为发病根本，导致左路肝木升发不足、右路肺金敛降失常、心火不潜、肾水失藏，最终气滞、痰凝、血瘀、毒结聚于肺络。治疗以培补中气、运转脾土为枢轴，辅以疏木达郁、清金降逆、泻南补北等法，恢复一气周流。结合现代肿瘤微环境、免疫代谢等研究，为中西医整合治疗NSCLC提供理论依据。

Abstract: Non-Small Cell Lung Cancer (NSCLC) remains one of the most challenging malignancies in contemporary oncology. Chinese medicine, by virtue of its holistic regulation, demonstrates unique advantages. Centered on Huang Yuanyu’s doctrine of “One Qi Circulating Endlessly, Four Emblems of Spleen-Earth”, this paper explores the pathodynamic evolution and therapeutic strategies of NSCLC. The authors propose that the fundamental pathogenesis lies in the collapse of central Qi and the failure of spleen-earth to transform and transport. Consequently, the ascending of liver-wood on the left pathway becomes insufficient, the descending of lung-metal on the right pathway is disturbed, heart-fire cannot dive, and kidney-water loses its storage. Eventually, qi stagnation, phlegm congelation, blood stasis and toxin accumulation coalesce in the pulmonary collaterals. The core therapeutic principle is to reinforce central Qi and activate spleen-earth as the pivot, assisted by methods of dredging wood to relieve depression, purging metal to descend counterflow, and “draining the south while tonifying the north”, so as to restore the endless circulation of the One Qi. Integrated with modern insights into the tumor microenvironment, immunity and metabolism, the theory provides a conceptual basis for combined Chinese-Western management of NSCLC.