“黜浊培本”理论由全国名中医贾英杰教授提出，在指导中医药治疗前列腺癌中有重要作用。围绕该理论，从理论阐释、证据整合与范式构建等方面进行梳理，系统阐释了“本元亏虚-癌浊胶结”动态病机模型，并论证了“补肾不如补脾”战略在规避雄激素风险与重塑肿瘤微环境方面的核心逻辑。临床实践方面，深度解析了以“健脾利湿化瘀方”为轴心的分期动态治疗体系，量化评估了其在联合治疗中“增效减毒”与“延迟耐药”的协同价值。机制研究层面，整合多学科证据，构建了从“多靶点协同预测”到“核心通路实验验证”，再到“肿瘤免疫微环境重塑”的立体作用网络，阐明了整合干预的生物学基础。进一步凝练了中医药干预的三大核心范式价值，并针对当前研究挑战，提出通过设计前瞻性平台试验、运用多组学技术、构建中医特色结局评价体系等策略，驱动该领域向循证与精准医学范式转型。

“Chuzhuo Peiben” theory, proposed by nationally renowned Chinese medicine expert Professor Jia Yingjie, plays an important role in guiding the treatment of prostate cancer with traditional Chinese medicine. This article reviews the theory from the perspectives of theoretical interpretation, evidence integration, and paradigm construction. It systematically elucidates the dynamic pathogenesis model of “deficiency of the primordial foundation-coagulation of cancerous turbidity” and demonstrates the core logic of the strategy “tonifying the spleen surpasses tonifying the kidney” in circumventing androgen-related risks and remodeling the tumor microenvironment. In terms of clinical practice, it analyzes the staging-based dynamic treatment system centered around the “Jianpi Lishi Huayu Formula” and evaluates its synergistic value in combined therapy for “enhancing efficacy and reducing toxicity” and “delaying drug resistance.” At the mechanistic level, it integrates multidisciplinary evidence to construct a stereoscopic action network that spans from “multi-target synergistic prediction” to “core pathway experimental validation” and further to “tumor immune microenvironment remodeling,” thereby clarifying the biological basis of integrative intervention. The review also summarizes three core paradigmatic values of TCM intervention. In response to current research challenges, it proposes strategies such as designing prospective platform trials, applying multi-omics technologies, and constructing TCM-specific core outcome sets to promote the development of this field toward evidence-based and precision medicine paradigms.

R285

天津中医药大学第一附属医院科研基金项目（院XB2024007）；天津市卫健委项目（2025050）