“痰瘀互结”与肿瘤微环境：中医病机的现代生物学阐释

Phlegm-Stasis Intermingling and Tumor Microenvironment: A Modern Biological Elucidation of Traditional Chinese Medicine Pathogenesis

摘要: 目的：以中医“痰瘀互结”理论为基础，探讨其与肿瘤微环境病理机制之间的关系，为中医药调控肿瘤微环境提供理论依据。方法：采用文献梳理与理论分析的方法，阐述中医视角“痰瘀互结”的理论内涵及与肿瘤微环境在免疫抑制、血管生成异常、代谢重编程等方面的机制对应。结果：“痰瘀互结”在物质基础、功能效应和动态演进三个层面与肿瘤微环境的病理特征存在对应关系：痰浊类似于免疫抑制性细胞因子网络和代谢废物蓄积，瘀血类似于血管生成异常和细胞外基质重塑，痰瘀胶结的过程则与肿瘤微环境由免疫激活向免疫抑制的演进相类似。结论：“痰瘀互结”既是中医对肿瘤病理的宏观概括，也在一定程度上反映了肿瘤微环境的核心特征；单细胞转录组学可从细胞亚群层面为上述病机对应关系提供细胞学证据。

Abstract: Objective: Based on the traditional Chinese medicine (TCM) theory of phlegm-stasis intermingling (tanyu hujie), this study explores its correlation with the pathological mechanisms underlying the tumor microenvironment (TME), aiming to provide a theoretical basis for TME modulation with TCM. Methods: Literature review and theoretical analysis were adopted to interpret the theoretical connotation of phlegm-stasis intermingling from the TCM perspective, as well as its mechanistic correspondence with the TME in immunosuppression, aberrant angiogenesis, and metabolic reprogramming. Results: Phlegm-stasis intermingling corresponds to TME pathological features across three dimensions: material basis, functional outcome, and dynamic progression. Phlegm turbidity is analogous to the immunosuppressive cytokine network and accumulation of metabolic waste; blood-stasis mirrors aberrant angiogenesis and extracellular matrix remodeling; the binding of phlegm and stasis recapitulates the TME transition from immune-activated to immune-suppressed status. Conclusion: Phlegm-stasis intermingling represents not only a macroscopic TCM generalization of tumor pathology but also partly reflects core characteristics of the TME. Single-cell transcriptomics can furnish cytological evidence supporting the above-mentioned pathogenetic correspondence at the cellularsubset level.