中西醫免疫療法抗癌對話

免疫檢查點的研究發現開啟癌症治療革命史的新頁，現代中醫師躬逢其盛，應該隨時精進與生理學、病理學以及生技、科學研究領域的相關議題，方可知己知彼，共同為促進人類健康與生活質量盡最大的努力。世界衛生組織（WHO）已將癌症定義為可控制的慢性病，諾貝爾生醫獎也三度肯定科學家對免疫細胞研究的卓越貢獻，種種跡象透露出中西醫學治病思路之交集範圍已逐漸擴大，本文將仔細闡述始末，包括：皆主張以自身免疫力抗病、皆重視細胞生存的微環境、皆認同積極干預方式不如與病和平共存等觀念。若分析科學界數十年來研究成果，可見免疫療法的出現是人類向內觀照、反諸訴求以全人照顧為本的必然產物，但對於中醫學理而言，這些理念卻再也熟悉不過，此部份將以傷寒論六經傳變的角度作深入探討。單一免疫檢查點抑制劑的療效統計目前僅三～四成，而基因改造的細胞療法也因費用與風險雙居高位而短時間內難以普及，可見中西醫需分頭突破重圍的挑戰還很多。而中醫在這舞台上應扮演如何的角色？應如何利用手中籌碼以畢其功？筆者由上段論點再擴充，進一步分析陰平陽秘與細胞微環境、腸胃論與腸道菌叢等，並整理中醫界在免疫檢查點抑制藥物與幹細胞的研究成果，試圖整理中醫治癌理論與免疫療法的異同處。

關鍵字

免疫藥物療法與細胞療法；中醫證病合辨；中醫治癌；針灸治療

並列摘要

Research into the immune checkpoints system opens up a new page in revolutionary cancer therapies. Today's Chinese medicine physicians must improve their knowledge of physiology, pathology, biotechnology and scientific research in order to understand and evolve along with these modern developments. Rooted in tradition and progressing into the future is the only way we can make the most beneficial contributions to health and quality of life. The World Health Organization (WHO) has defined cancer as a controllable chronic disease. Three Nobel Prizes being awarded in physiology or medicine have also affirmed the extraordinary contributions of scientists involved in immunotherapy and cell therapy research. Increasingly impelling indications reveal that the scope of integrative Chinese and Western medicine is expanding. This paper will introduce these areas of common ground in detail, including advocating autoimmunity against disease, the focus on cell survival in the neoplastic microenvironment, and agreeing that peaceful coexistence with disease offers greater potential for superior outcomes compared to aggressive intervention. An analysis of the research results of the scientific community over the past few decades clearly shows that the emergence of immunotherapy is an inevitable outcome of human beings introspection and appeals for a holistic approach to treatment. But in Chinese medicine these concepts form the underlying foundations of our theoretical basis and therapeutic approach, with an in-depth discussion of the six channel transmutations introduced in On Cold Damage and Miscellaneous Diseases presented to elucidate this premise. The efficacy of immune checkpoint inhibitors as single agents is currently only 30% to 40%, and genetically modified cell therapy is also difficult to universalize in a short period of time because of the high costs and risks. There are obviously still many challenges for integrative Chinese and Western medicine to overcome. What role should Chinese medicine have on this stage? How can we use the available resources to actualize our goals? The author further expands upon the previous paragraph to analyze the relationships involving concepts such as calm yin and sound yang and intracellular environment and On the Spleen and Stomach and intestinal flora. Moreover, results of research done by the Chinese medicine community on immune checkpoint system inhibitors and stem cells are presented in attempts to organize the similarities and differences of the Chinese medicine cancer treatment approach and immunotherapy.

並列關鍵字

immunotherapy and cell therapy ； Chinese medicine pattern differentiation ； Chinese medicine cancer treatment ； acumoxatherapy

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