【摘要】 随着免疫检查点疗法为代表的免疫治疗在临床上广泛应用，结直肠癌的治疗手段得到了进一步拓展。然而，占85%的微卫星稳定型结直肠癌对免疫治疗不应答，严重限制了其推广应用。微卫星稳定型结直肠癌抵抗免疫治疗有两个关键机制：一是在免疫平衡阶段前期，肿瘤细胞的低抗原克隆选择导致肿瘤抗原不足，抗原提呈失败，T细胞无法激活；二是在免疫平衡阶段后期，肿瘤微环境形成，进一步支撑肿瘤发展。本文通过正邪和阴阳两个维度探讨了微卫星稳定型结直肠癌的中医特点，将其归纳为“正气阴阳不足，邪气阴盛阳藏”,提出在以扶正祛邪为基本治疗原则的前提下，发现伏藏邪阳以及迫使邪阳浮现是中医药改善免疫治疗抵抗的关键。更多还原

【Abstract】 With the extensive application of immunotherapy, particularly immune checkpoint therapy, in clinical practice, the treatment options for colorectal cancer have been further expanded. However, 85% of microsatellite stable(MSS) colorectal cancers exhibit resistance to immunotherapy, which seriously limits the promotion of immunotherapy for colorectal cancer. There are two key mechanisms that contribute to this immunotherapy resistance: Firstly, in the early equilibrium stage of cancer immunoediting, the low immunogenic subclonal selection of tumor cells lead to insufficient tumor antigens, which causes failure of antigen presentation and inactivation of T cells; Secondly, the formation of the tumor microenvironment in the later equilibrium stage further supports the development of tumors. This study explores the characteristics of traditional Chinese medicine in addressing MSS colorectal cancer from the perspective of the healthy Qi-pathogenic factors and Yin-Yang dynamics, categorizing these attributes as a "deficiency of Yin and Yang in healthy Qi, alongside an excessive abundance of Yin and deep concealment of Yang in pathogenic factors". Therefore, we propose that under the basic treatment principle of reinforcing healthy Qi while eliminating pathogenic factors, uncovering hidden pathogenic Yang and forcing it to emerge is key for ameliorating resistance to immunotherapy.更多还原