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肿瘤的发病机制十分复杂，现代研究认为其发生发展与机体免疫功能密切相关，调节免疫系统功能是肿瘤防治的关键手段。肠道黏膜免疫是免疫系统的重要组成部分，可影响疾病预后并干预治疗效果。中医学认为“脾为之卫”是对于脾脏以卫气为介行使防御功能的高度概括。肠道黏膜免疫部位在肠，功能属脾，与中医“脾为之卫”理论高度吻合。肠道黏膜免疫稳态失衡与“脾为之卫-脾失为卫”的病理转化过程相似，“脾失为卫”或为肿瘤发病的中医机制。以“脾为之卫”为切入点，探讨肿瘤肠黏膜免疫稳态失衡与“脾失为卫”的相关性及临床应用，以期为从“治脾调卫”恢复肠黏膜免疫稳态角度防治肿瘤提供理论依据。
Abstract：The pathogenesis of tumors is very complex. Modern research suggests that their occurrence and development are closely related to the immune function of the body. Regulating the function of the immune system is a key approach of tumor prevention and treatment. Intestinal mucosal immunity is an important component of the immune system,which can affect the prognosis of diseases and intervene in the therapeutic effect. Traditional Chinese medicine(TCM) holds that “ spleen acting as the protector of the body”,which is a highly summarized description of the spleen's defense function through the medium of defensive qi. The immune site of the intestinal mucosa is located in the intestine,and its function belongs to the spleen,which is highly consistent with the theory in TCM that “spleen acting as the protector of the body”. The imbalance of intestinal mucosal immune homeostasis is similar to the pathological transformation process of “spleen acting as the protector of the body-the spleen failing to act as the protector of the body”,and “the spleen failing to act as the protector of the body” may be the mechanism of tumor occurrence in TCM. This article takes “spleen acting as the protector of the body” as the entry point to explore the correlation and clinical application between the imbalance of intestinal mucosal immune homeostasis in tumors and “the spleen failing to act as the protector of the body”,in order to provide a theoretical basis for the prevention and treatment of tumors from the perspective of “treating the spleen and regulating the protector of the body” to restore intestinal mucosal immune homeostasis.
[1]SUNG H,FERLAY J,SIEGEL R L,et al. Global cancer statistics 2020:globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin,2021,71(3):209-249.
[2]TSAI Y L,LIN T L,CHANG C J,et al. Probiotics,prebiotics and amelioration of diseases[J]. J Biomed Sci,2019,26(1):3.
[3]王大鹏，关徐涛，于冬冬.《黄帝内经》肿瘤病理论浅谈[J].新中医，2021,53(6):85-88.
[4]刘杰民，蔺晓源，王敏，等.基于肠道黏膜免疫的“脾为之卫”理论探讨[J].中国中医基础医学杂志，2013,19(4):460,466.
[5]许慎.说文解字[M].汤可敬，译注.北京：中华书局，2018:406.
[6]黄元御.灵枢悬解[M].张暖，校注.北京：人民军医出版社，2015:136.
[7]孙一奎.医旨绪余[M].王雅丽，校注.北京：中国医药科技出版社，2012:26.
[8]张秉成.成方便读[M].杨威，校注.北京：中国中医药出版社，2002:37.
[9]赵雨薇，亓润智，花宝金.花宝金“扶正调气”防治肿瘤思想与经验探析[J].辽宁中医杂志，2022,49(3):16-19.
[10]马祥雪，温永天，尹晓岚，等.从“脾为之卫”理论探讨肠道黏膜免疫与溃疡性结肠炎的中医机制[J].世界科学技术-中医药现代化，2024,26(3):640-645.
[11]张贺，王玉娥，陈洪岩.肠道菌群参与宿主免疫应答的作用及机制研究进展[J].微生物学报，2020,60(4):629-640.
[12]XIE Y,XIE F,ZHOU X,et al. Microbiota in tumors:from understanding to application[J]. Adv Sci,2022,9(21):e2200470.
[13]TONG Y,GAO H,QI Q,et al. High fat diet,gut microbiome and gastrointestinal cancer[J]. Theranostics,2021,11(12):5889-5910.
[14]ALIZADEHMOHAJER N,SHOJAEIFAR S,NEDAEINIA R,et al. Association between the microbiota and women’s cancers:cause or consequences?[J]. Biomed Pharmacother,2020,127:110203.
[15]姚望，李和根，田建辉.菌群的黏膜免疫调控与恶性肿瘤防治[J].中国肿瘤生物治疗杂志，2021,28(3):306-310.
[16]DZUTSEV A,BADGER J H,PEREZ-CHANONA E,et al. Microbes and cancer[J]. Annu Rev Immunol,2017,35:199-228.
[17]姜婷，纪文岩，陆为民.从肠道菌群浅析“脾为之卫”的科学内涵与临床应用[J].中国中西医结合杂志，2020,40(10):1268-1272.
[18]ODENWALD M A,TURNER J R. The intestinal epithelial barrier:a therapeutic target[J]. Nat Rev Gastroenterol Hepatol,2017,14(1):9-21.
[19]NAAMA M,TELPAZ S,AWAD A,et al. Autophagy controls mucus secretion from intestinal goblet cells by alleviating ER stress[J]. Cell Host Microbe,2023,31(3):433-446.e4.
[20]KNOOP K A,NEWBERRY R D. Goblet cells:multifaceted players in immunity at mucosal surfaces[J]. Mucosal Immunol,2018,11(6):1551-1557.
[21]聂烁，闻正顺.肠道黏蛋白2的分泌、结构、合成调控及其在肠道疾病发生发展中的作用[J].动物营养学报，2020,32(6):2521-2532.
[22]SALZMAN N H,UNDERWOOD M A,BEVINS C L.Paneth cells,defensins,and the commensal microbiota:a hypothesis on intimate interplay at the intestinal mucosa[J]. Semin Immunol,2007,19(2):70-83.
[23]GOGUYER-DESCHAUMES R,WAECKEL L,KILLIAN M,et al. Metabolites and secretory immunoglobulins:messengers and effectors of the host-microbiota intestinal equilibrium[J]. Trends Immunol,2022,43(1):63-77.
[24]WELLS J M,BRUMMER R J,DERRIEN M,et al. Homeostasis of the gut barrier and potential biomarkers[J]. Am J Physiol Gastrointest Liver Physiol,2017,312(3):G171-G193.
[25]张介宾.景岳全书[M].北京：中国中医药出版社，1994:276.
[26]周联，黄绍伟，罗霞，等.肠道黏膜免疫进展为中药免疫研究提供的机遇[J].中国免疫学杂志，2019,35(24):2945-2952.
[27]MÖRBE U M,JØRGENSEN P B,FENTON T M,et al.Human gut-associated lymphoid tissues(GALT);diversity,structure,and function[J]. Mucosal Immunol,2021,14(4):793-802.
[28]COOK D N,PISETSKY D S,SCHWARTZ D A. Tolllike receptors in the pathogenesis of human disease[J].Nat Immunol,2004,5(10):975-979.
[29]马丽娟，王锡恩，张静，等.益气健脾方对宫颈癌同步放化疗脾虚证候及免疫状态的影响[J].中华中医药学刊，2020,38(10):236-239.
[30]GANGOSO E,SOUTHGATE B,BRADLEY L,et al.Glioblastomas acquire myeloid-affiliated transcriptional programs via epigenetic immunoediting to elicit immune evasion[J]. Cell,2021,184(9):2454-2470.e26.
[31]李中梓.医宗必读[M].北京：中国医药科技出版社，2018:253.
[32]张从正.儒门事亲[M].王雅丽，校注.北京：中国医药科技出版社，2019:41.
[33]王淑，王信，孙萍，等.基于UPLC-Q-TOF-MS技术的白花蛇舌草干预结肠炎相关结肠癌小鼠血清代谢组学分析[J].中国实验方剂学杂志，2021,27(6):94-104.
[34]李国旺，吴佳伟，高秀娟，等.蒲公英抗肿瘤研究进展[J].中国中医药现代远程教育，2024,22(1):157-159.
[35]王吉锡，孟丹，李洪源.中药连翘提取物抗肿瘤作用的研究现状[J].黑龙江科技信息，2016(3):94.
[36]张明发，沈雅琴.厚朴酚抗肿瘤药理作用及其机制的研究进展[J].抗感染药学，2022,19(6):783-787.
[37]邱奕飞，张潇雪，肖国生，等.枳壳黄酮提取物抑制结直肠癌肿瘤细胞增殖活性的研究[J].食品工业，2023,44(5):199-204.
[38]宋洁，郭瑞芳，聂虹，等.木香烃内酯对溃疡性结肠炎小鼠肠道免疫炎症的影响及其机制[J].广西医科大学学报，2021,38(12):2300-2305.
[39]何燕珊.白术炮制前后的质量分析及对溃疡性结肠炎大鼠的作用研究[D].广州：广东药科大学，2021.
[40]刘丝雨，刘洁，程博，等.茯苓多糖及三萜类成分抗肿瘤的研究进展[J].中国实验方剂学杂志，2023,29(5):257-263.
[41]赵小强，汪丽娜，索强，等.党参及其有效成分的抗肿瘤作用研究进展[J].中医药导报，2024,30(3):121-125,155.
[42]李华，郭丽，憨镔，等.参苓白术散化裁对胃癌术后化疗患者肠道菌群、肠屏障和免疫功能的调节作用分析[J].肿瘤药学，2020,10(4):477-482.
基本信息:
DOI：10.16295/j.cnki.0257-358x.2026.01.004
中图分类号:R273
引用信息:
[1]原雅敏,戴义宁,李慧杰,等.从肠道黏膜免疫稳态探讨“脾为之卫”与肿瘤免疫的相关性[J].山东中医杂志,2026,45(01):17-22.DOI:10.16295/j.cnki.0257-358x.2026.01.004.
基金信息:
山东省自然科学基金项目（编号：ZR2021LZY029）
2024-08-25
2024
2024-11-25
2024
1
2026-01-05
2026-01-05