中医中药在癌症治疗中的应用及其机理

急性早幼粒细胞白血病的特点：出血
A significant proportion of patients (20–30%) died rapidly of cerebral haemorrhage
“It seems to be the most malignant form of acute leukemia”
Wang, Chen
Leukemic cells return to normal?
Differentiation of teratocarcinoma and neuroblastoma cells (Pierce, Schubert) Induction of differentiation of promyelocytic leukemia cells by retinoic acid (Breitman et al, 1980).
Lancet 2013; 381: 133–41
禁烟与癌症
三、环境污染
PM2.5对健康的影响
Restricted-activity days Respiratory diseases (e.g., asthma, bronchitis, COPD)
Cardiac disorders
Cancer
中药抗肿瘤的应用和药理
癌症概况
癌症概况
癌症的病因
Intrinsic processes and extrinsic factors relate to cancer risks through stem-cell division
坏运气还是环境因素？
一、人口老龄化
250000 200000
征服急性早幼粒细胞白血病的历程
治疗APL：中医理念与西医方法
Confucius
“If you use laws to direct the people, and punishments to control them, they will merely try to evade the laws, and will have no sense of shame. But if by virtue you guide them, and by the rites you control them, there will be a sense of shame and of right.”
二、吸烟
• Chinese tobacco products account for 1/3 of the total world amount
• China has 350 M smokers • Amount of smoking of Chinese is still rising
吸烟与寿命
GDP 100 million RMB
150000
100000
50000 0
5689.8 1978
18774 1986
67795 1996
209407 2006
The common biology of cancer and ageing
A stem cell perspective on cancer and ageing. Nature 2007
七、遗传因素
Angelina Jolie
八、肥胖
九、其他原因
➢运动少 ➢压力、负性情绪
癌症的基本特征
靶向疗法的策略
中医肿瘤学：病机与治则
病机 ➢ 阴阳失调 ➢ 正虚邪实 ➢ 脏腑失调 ➢ 气滞血瘀 ➢ 痰结湿聚 ➢ 热毒内蕴
治则
➢ 调整阴阳 ➢ 扶正祛邪 ➢ 软坚散结 ➢ 活血化瘀 ➢ 化痰祛湿 ➢ 清热解毒 ➢ 以毒攻毒
40-90%，平均为59%。 ➢ 1994年被世界卫生组织/国际癌
症研究机构定为Ⅰ类致癌原 ➢ 约有1%的感染者会发展为胃癌 ➢ 65%的胃癌与幽门螺杆菌有关
六、不良生活习惯
➢ “粗粮”：胃癌 ➢ “细粮”：直肠癌 ➢ 腌制食品：胃癌。 ➢ 河南林县食管癌高发：吸烟、过高温度/粗糙/腌
制的食物、HPV ➢ 江苏启东：黄曲霉素 ➢ 云南宣威：烟煤
Caused by the occurrence of fibrinogenopenia and disseminated intravascular coagulation that is often worsened by chemotherapy
急性早幼粒细胞白血病的特点：染色体易位
急性早幼粒细胞白血病的发病机理
n=34439 Follow up: 50 years Started at 35 years old
每吸一根烟寿命减少10分钟
Baidu Nhomakorabea
Hazards of smoking: a prospective study of 1 million women in the UK
12-year relative risk, current smoker versus never-smoker, by amount smoked
Pre-mature death Developmental effects Others
四、慢性病毒感染
• HPV and cervical cancer • EBV and nasopharyngeal carcinoma • HBV and liver cancer
五、慢性细菌感染
➢ 革兰氏阴性，微需氧，螺旋状 ➢ 世界一半人口感染幽门螺杆菌 ➢ 在我国，幽门螺杆菌感染率为
与西医的抗肿瘤药物开发相同，耗时较长 4. 新策略：
常用中药→活性成分→靶标、适应症→母药治肿瘤 关键词：靶标、活性成分、药物
砷、PML-RARα与急性早幼粒细胞白血病
急性早幼粒细胞白血病的特点：细胞
Auer rods
Promyelocytes comprise 30 to 90 percent of marrow cells
系将 ，西 进医 而研 促究 进成 中果 医纳 肿入 瘤中 学医 发理 展论 ？体
中药仅在少数肿瘤中取得显著疗效，应该有更大作为
中医抗肿瘤药物开发、国际化的策略
1. 方药有效→找出靶标、阐明机理→推广应用 理想的方法，但实例较少
2. 中药活性成分/先导化合物→靶标、适应症→药物 3. 靶标→中药活性成分/先导化合物→药物