基于三物白散逆转荷瘤机体Th1/Th2漂移探讨"祛邪以扶正"治则应用规律

Positively immunity effect of cell modulate of San Wu Bai San in the phrase of antitumor have been confirmed in the preliminary research and the relevant research provided a definitive basis for using the rule of "strengthening the body resistance to eliminate pathogenic factors" in application of tumor clinical treatment. However, if we purport to use " eliminating pathogenic factors " rule to achieve " strengthening the body resistance " must follow the application of the law depending on the TCM theory. The drafting task will use the positively immunity effect of San Wu Bai San Cell modulate in the phrase of antitumor as the frame of reference. And focus on the Th1/Th2 reverse shift, choose tumor-bearing bodies in different pathological state as intervention objects. Observe the best compound dosage and the intervention cycle of implemented the Th1/Th2 reverse shift effect for different pathological conditions by San Wu Bai San, reveal the applied law of using the rule of "strengthening the body resistance to eliminate pathogenic factors" with the pathological state initially. On the basis of the aforementioned study, by revealing the cell biological characteristics of the tumor groups in tumor-bearing body under the pathological state which show the rule of "strengthening the body resistance to eliminate pathogenic factors", the research will clear the close attention to the body pathological state in the rule of "strengthening the body resistance to eliminate pathogenic factors".Then breakthrough the embarrassing situation of the traditional "eliminate pathogenic factors" therapeutic research only concerns about the medicine of it, provide more objective and direct evidences for properly using the rule of "strengthening the body resistance to eliminate pathogenic factors" in tumor clinical treatment.

三物白散抗肿瘤过程中细胞免疫正相调节效应已得到前期研究证实，相关研究为肿瘤临床应用"祛邪以扶正"治则提供了确切依据。然而，依据中医传统理论，欲使"祛邪"治则实现"扶正"之用必须遵循相关应用规律。拟申请课题将以三物白散实现抗肿瘤细胞免疫正相调节效应为基本参照，着眼于Th1/Th2漂移逆转这一关键，选择肿瘤初、中、末不同分期的荷瘤机体为干预对象，观察三物白散在不同分期实现Th1/Th2漂移逆转效应对应的干预时程、干预强度、干预疗程等内容，从祛邪治则方药本身找到产生扶正效应的最佳组合。在此基础上，对产生前述效应的荷瘤鼠免疫状态、肿瘤群体细胞病理学特征的揭示，以期进一步明确"祛邪以扶正"治则干预对象的特征。通过上述研究，将可以较为系统全面的阐述"祛邪以扶正"治则应用规律。

本课题立足于目前抗肿瘤中药复方研究存在的误区及实验研究与临床抗肿瘤方药应用缺乏内在联系的事实，紧密结合临床实际，首次运用祛邪方在肿瘤各期干预荷瘤机体并观察其在肿瘤进展全过程中的应用规律。. 在课题具体实施过程中，首先运用正交设计观察祛邪方三物白散不同干预时间点、不同剂量、不同给药疗程三个因素的四个水平分别作用于荷瘤鼠的效应差异，得出在肿瘤前、初、中、末期三物白散发挥抗肿瘤效应的最佳因素水平组合，进而揭示温下祛邪法在肿瘤不同病理阶段所起到的作用。同时，通过动态观察接种肿瘤后不同病程阶段的荷瘤小鼠基本生活状态及相关免疫指标，总结了荷瘤鼠整体病程中的正邪变化分为四个阶段：正盛邪弱、正邪相当、邪盛正未衰、邪盛正衰，这一认识与中医临床对于肿瘤患者“正”、“邪”变化认识相吻合。并呼应第一部分实验所得三物白散应用规律，综合得出祛邪治则在抗肿瘤治疗中应遵循的使用原则——在肿瘤治疗过程中应当是根据机体病理状态变化而灵活遣方用药。. 本课题提出应当重视中医治则干预病理状态选择的新理念，改变了过去研究治则应用规律仅注意祛邪方药本身的研究方法，使得对治则应用规律的把握变得更加准确；弥补了过去对治则应用规律仅局限于定性层次的不足，从治则干预强度、干预时间、干预疗程等定量视角对其应用规律做出的揭示，不仅有利于“祛邪以扶正”治则更准确地指导临床实践，也为中医其他治则应用规律的研究开拓了新的思路与方法。基于肿瘤进展全程荷瘤机体状态动态观察某种治法或方药的抗肿瘤效应及应用规律，可成为今后中医肿瘤研究一重要关注点。