中医杂志2026，Vol.67Issue(7)：730-735,6.DOI:10.13288/j.11-2166/r.2026.07.006
基于少阳少阴主枢理论探讨胃癌免疫治疗分期分阶段辨治思路
Exploration of the Staged and Phased Differentiation and Treatment Approach for Gastric Cancer Immuno-therapy Based on the Theory of Shaoyang(少阳)and Shaoyin(少阴)as the Pivots
摘要
Abstract
Based on the theory that Shaoyang(少阳)and Shaoyin(少阴)function as the principal pivots,and integrating the laws of qi-fire transformation,yin-yang alternation,and the waxing and waning of healthy qi and patho-genic factors,as well as the action characteristics of immune checkpoint inhibitors(ICIs),this study systematically expounds the dynamic evolution laws of the Shaoyang and Shaoyin pivots and constructs a stage-and phase-based dif-ferentiation and treatment framework for gastric cancer immunotherapy.In the neoadjuvant treatment stage,the core pathogenesis is the dysfunction of the Shaoyang pivot and the disorder of qi and fire transformation,often accompa-nied by stagnation of cold-deficiency in the middle jiao(焦).In the postoperative adjuvant treatment stage,the domi-nant factors are the depletion of Shaoyin fire and the damage of yin fluid,accompanied by the lingering of residual pathogen in the Shaoyang level and the obstruction of collaterals by phlegm and stasis.In the advanced stage,the critical conditions are the exhaustion of the Shaoyin pivot,the blockage of orifices by turbid toxins,and the separation of yin and yang,leading to the rampant of pathogenic toxins and the emergence of various complicated syndromes.The treatment should be guided by the principle of regulating the double pivot.In the neoadjuvant treatment stage,it is recommended to activate the Shaoyang pivot and warm and promote the qi movement in the middle jiao.In the post-operative adjuvant treatment stage,clearing the residual pathogenic factors from the pivot and nourishing the Shaoyin.In the advanced stage,rescuing the Shaoyin pivot and opening the orifices to transform turbidity.Furthermore,stage-based treatment should serve as the foundation for dynamically assessing the patient's immune status and phase-specific changes in immunity,thereby promoting immune activation while preventing and managing immune overactivation and drug resistance.关键词
胃癌/免疫检查点抑制剂/免疫相关不良事件/耐药/少阳/少阴Key words
gastric cancer/immune checkpoint inhibitors/immune-related adverse events/drug resistance/shaoyang(少阳)/shaoyin(少阴)引用本文复制引用
张文康,葛媛莎,刘可心,李杰..基于少阳少阴主枢理论探讨胃癌免疫治疗分期分阶段辨治思路[J].中医杂志,2026,67(7):730-735,6.基金项目
国家重点研发计划(2023YFC3503300,2023YFC3503301,2023YFC3503302,2023YFC3503303,2023YFC3503304) （2023YFC3503300,2023YFC3503301,2023YFC3503302,2023YFC3503303,2023YFC3503304）
中国中医科学院科技创新工程重大攻关项目(CI2021A01802) （CI2021A01802）
中央高水平中医医院临床科研业务费(HLCMHPP2023001,HLCMHPP2023097) （HLCMHPP2023001,HLCMHPP2023097）
福建省第三批柔性引进医疗卫生高层次人才团队 （）
