Exploring the Mechanism and Treatment Strategies of Hepatitis-Carcinoma Transformation from the Perspective of the Xuanfu-Qi-Blood-Collaterals Theory

Author：LI Rongzhi1, ZHAO Changpu2, ZHANG Yu1, XU Yuying1, LI Zishun1, CHEN Renwu1, LI Meiling1, HAO Chenyuan1

Unit：1.The Second Clinical Medical College of Henan University of Chinese Medicine, Zhengzhou Henan 450002, China; 2.Henan University of Chinese Medicine, Zhengzhou Henan 450002, China

Quote：引用：李荣枝，赵长普，张雨，许钰颖，李子舜，陈仁伍，李美玲，郝晨源.基于“玄府-气血-络脉”理论探析肝炎癌转化机制及论治[J].中医药导报,2026,32(2):117-123.

DOI：10.13862/j.cn43-1446/r.2026.02.019

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Abstract：

The development of hepatocellular carcinoma (HCC) is closely associated with the "inflammation-cancer transformation" process from chronic hepatitis to liver fibrosis and cirrhosis. Based on the "Xuanfu-Qi-Blood-Collaterals" theory, this paper proposes "obstruction of Xuanfu, disharmony of Qi and Blood, and deficiency-stagnation of collaterals" as the key pathogenesis. Xuanfu, serving as the microscopic gateway for the distribution of Qi, Blood, and body fluids, becomes dysfunctional, leading to structural abnormalities in liver sinusoidal endothelial cells and stagnation of Qi and Blood. Disharmony of Qi and Blood triggers mitochondrial dysfunction and oxidative stress, damaging liver collaterals. Deficiency-stagnation of collaterals forms the pathological basis for the accumulation of phlegm, stasis, and toxins. These three aspects together constitute a vicious cycle of "stasis-toxin-obstruction," ultimately progressing to HCC. This paper advocates a treatment principle of "simultaneous dredging and tonifying": using wind-dispersing herbs to open Xuanfu and relieve obstruction, harmonizing Qi and Blood to resolve phlegm and stasis, and tonifying deficiency to restore collateral function. Furthermore, targeting different etiologies such as metabolic-associated fatty liver disease, alcoholic liver disease, and viral hepatitis, Chinese herbs including Qinghao (Artemisia annua), Gegen (Pueraria lobata), and Danshen (Salvia miltiorrhiza) are selected to regulate metabolism, reduce inflammation, and modulate the immune microenvironment through multi-target effects, thereby blocking the "inflammation-cancer transformation" process. This paper elucidates the core pathogenesis and therapeutic rationale for HCC, aiming to restore the dynamic balance among Qi, Blood, Xuan Fu, and collaterals to achieve "preventing progression in established disease and preemptive intervention before disease onset." It provides a reference for integrated traditional Chinese and Western medicine intervention in HCC transformation pathways.

Key words：hepatocellular carcinoma; inflammation-cancer transformation; Xuanfu-Qi-Blood-Collaterals; simultaneous dredging and tonifying; traditional Chinese medicine treatment; pathogenesis evolution

摘要：肝癌的发生与慢性肝炎至肝纤维化、肝硬化的“炎癌转化”进程密切相关。本文基于“玄府-气血-络脉”理论，提出“玄府郁闭，气血失和，络脉虚滞”的关键病机。玄府作为气血津液输布的微观门户，其开阖不利致肝窦内皮结构异常，气血壅滞；气血失和引发线粒体功能障碍及氧化应激，损伤肝络；络脉虚滞则形成痰瘀毒结的病理基础；三者共同构成“瘀-毒-闭”恶性循环，最终进展为肝癌。本文主张以通补兼施为治疗原则，用风药开玄通闭，和气血以祛痰化瘀，补虚通络以复肝络功能。同时，针对代谢相关脂肪肝、酒精性肝病及病毒性肝炎等不同病因，选用青蒿、葛根、丹参等中药多靶点调节代谢、抗炎及调节免疫微环境，阻断“炎癌转化”进程。本文重点阐释了肝癌核心病机与治疗依据，通过复气血玄络的动态平衡实现“既病防变、未病先防”，旨在为中西医结合干预肝癌转化路径提供参考。

关键词：肝癌；炎癌转化；玄府-气血-络脉；通补兼施；中医药治疗；病机演变

Release time：2026-03-05

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