肝脏“炎–癌转化”中炎症因子–信号通路的中西医结合调控机制研究

Study on Integrated Chinese-Western Medicine Regulatory Mechanism of Inflammatory Factors-Signaling Pathways in Liver “Inflammation-Cancer Transformation”

摘要: 本研究系统梳理肝脏“炎–癌转化”进程中核心炎症因子、经典信号通路的作用网络，结合中医病机理论、中药活性成分及经典复方的现代药理研究，探究中西医协同调控该病理过程的作用机制，为肝病防癌变提供理论支撑与实践参考。慢性肝损伤诱发的持续炎症微环境是肝细胞恶性转化的核心诱因，IL-6、TNF-α等炎症因子异常高表达，联动激活Wnt/β-catenin、Ras/Raf/MAPK、Hedgehog、NF-κB、Notch、PI3K/AKT等多条信号通路，形成复杂调控网络，共同推动炎症、肝纤维化向肝癌进展。中医将本病归属于“胁痛”“癥积”“积聚”范畴，以正气亏虚、伏邪毒蕴、痰瘀互结为核心病机，病机演变遵循肝气郁结，肝郁脾虚，痰瘀成癥，癌毒内生的规律。中药及其活性成分、中药经方及现代复方，可多靶点抑制促炎因子、阻断异常信号通路、调节机体免疫、逆转肝纤维化，兼具整体调理与精准干预的优势。中西医结合模式融合西医靶向通路、中医扶正祛邪的特点，能够有效截断肝脏“炎–癌转化”转化链条，在肝病防治领域具备广阔应用前景。

Abstract: This study systematically sorts out the action network of core inflammatory factors and classic signaling pathways in the progression of liver “inflammation-cancer transformation”. Combined with modern pharmacological researches on TCM pathogenesis theories, active components of Chinese herbal medicines and classical compound prescriptions, it explores the mechanism of integrated Chinese-western medicine in synergistically regulating this pathological process, so as to provide theoretical support and practical references for preventing carcinogenesis of liver diseases. The persistent inflammatory microenvironment induced by chronic liver injury serves as the core incentive for malignant transformation of hepatocytes. Abnormally high expression of inflammatory factors such as IL-6 and TNF-α co-activates multiple signaling pathways including Wnt/β-catenin, Ras/Raf/MAPK, Hedgehog, NF-κB, Notch and PI3K/AKT, forming a complex regulatory network that jointly promotes the progression from inflammation and liver fibrosis to hepatocellular carcinoma. In traditional Chinese medicine, this disease is categorized into the domains of “hypochondriac pain”, “zhengji (abdominal masses)” and “accumulation”. Its core pathogenesis lies in healthy-qi deficiency, latent pathogen-toxin accumulation, as well as phlegm-blood stasis intermingling. The evolution of pathogenesis follows the sequence of liver-qi stagnation, liver-depression and spleen-deficiency, mass formation due to phlegm-blood stasis, and endogenous cancer toxin. Chinese herbal medicines, their active ingredients, classical formulas and modern compound prescriptions can multi-targetedly inhibit pro-inflammatory factors, block abnormal signaling pathways, regulate organism immunity and reverse liver fibrosis, possessing the advantages of holistic conditioning as well as precise intervention. The integrated Chinese-western medicine model combines western medicine targeted pathway therapy with the TCM principle of strengthening healthy qi and eliminating pathogenic factors, which can effectively cut off the chain of liver “inflammation-cancer transformation” and shows broad application prospects in the prevention and treatment of liver diseases.