A NovelTraditional Chinese Medicine Approach for Esophageal Cancer: Theoretical Construction and Modern Interpretation of the Sweet-Moistening and Nourishing Therapy

Based on Professor Li Jing's exploration of traditional Chinese medicine (TCM) classics and decades of clinical experience, this paper innovatively proposes that "dryness and depletion of the stomach and esophagus with concurrent consumption of blood and essence" constitutes the core pathogenesis throughout the entire course of esophageal cancer. According to this theory, esophageal cancer originates from stomach-esophageal dryness and depletion caused by fluid damage, subsequently evolving through a dynamic progression of fluid impairment-humor depletion-blood deficiency-essence exhaustion, ultimately leading to cachexia. On this basis, the Sweet-Moistening and Nourishing (Ganrun Ruyang) therapeutic principle and a staged prescription system were established, encompassing strategies from producing fluids with sweet-cool medicinals to supplementing the marrow and replenishing essence, matched with corresponding formulas. This theory is further systematically interpreted from the perspective of modern biology: "stomach-esophageal dryness and depletion" corresponds to local homeostatic disruption in the tumor microenvironment (TME), including weakened gap junctions, microfilament cytoskeleton rearrangement, epithelial-mesenchymal transition (EMT), macrophage polarization, and gut microbiota dysbiosis; "concurrent consumption of blood and essence" corresponds to systemic metabolic disorder and immunosuppression, involving glycolytic reprogramming, decreased body fluid proportion, abnormal amino acid metabolism, systemic inflammation, and nutritional depletion. The Sweet-Moistening and Nourishing therapy achieves the principle of simultaneously treating the symptoms by clearing heat and moistening dryness while consolidating the root by nourishing blood and replenishing essence, through multi-target approaches such as stabilizing cell junctions, blocking the Gas6/Axl-NF-κB axis, ameliorating immunosuppression, rectifying metabolic disturbances, and modulating the microbiota-metabolite-immune axis. This provides a theoretical foundation for the integrated traditional Chinese and Western medicine treatment of esophageal cancer.