基于"痞坚之处,必有伏阳"探讨中医辨治肾癌的理论与临床实践OA

Renal cell carcinoma(RCC),a urological malignancy with persistently increasing global incidence,presents significant clinical challenges including the loss of surgical opportunities in advanced-stage patients and resistance to targeted therapies.Grounded in the traditional Chinese medicine(TCM)theory that"where there is hardness and stagnation,there must be latent Yang",this study challenges the conventional pathogenesis perspective that"stagnation causes latent Yang"and instead proposes the novel tumor pathogenesis theory that"latent Yang causes stagnation".The core pathology of RCC is identified as internal disturbance of latent Yang and dysfunction of Qi transformation,which subsequently leads to the accumulation of phlegm,blood stasis,and toxins,ultimately resulting in the formation of renal masses.Our research reveals that characteristic RCC features-including hypoxia-inducible factor activation,hyperactive glycolytic metabolism,and the immunosuppressive tumor microenvironment-show remarkable congruence with the TCM pathogenesis concept of"internal stagnation-heat".Based on these findings,we have developed an innovative therapeutic strategy that combines root treatment(clearing and dispersing latent Yang,harmonizing Yin and Yang,and reinforcing earth to subdue Yang)with branch treatment(resolving stagnation and hardness).This approach employs heat-clearing and pathogen-eliminating methods to improve tumor hypoxia and toxin-resolving and nodule-dispersing therapies to modulate the immune microenvironment,thereby not only embodying the fundamental TCM principle of"treating disease at its root"but also aligning with contemporary tumor microenvironment intervention strategies.This study provides groundbreaking theoretical insights and therapeutic approaches for TCM intervention in RCC,offering significant clinical implications for addressing targeted therapy resistance and improving patient prognosis.