Research on Tumor Drug Resistance Mechanisms Based on the “Deficiency-Excess Pathogenesis” Theory from The Huangdi Neijing and Advances in Traditional Chinese Medicine’s “Strengthening the Healthy Qi and Eliminating Pathogenic Factors” Approach

Cancer remains a difficult disease to conquer in modern medicine, and cancer drug resistance is a common phenomenon in clinical chemotherapy. This issue has become a major challenge in clinical practice, and there is an urgent need for a profound understanding of its mechanisms and the exploration of solutions. The Huangdi Neijing proposes the core pathogenesis that “when pathogenic factors are excessive, it constitutes a ‘full’ pattern; when vital energy is depleted, it constitutes a ‘deficient’ pattern,” elucidating the dynamic relationship between the excess of cancerous toxins (full) and the insufficiency of vital energy (deficient) in tumor drug resistance. Currently, with the continuous deepening of research into the molecular mechanisms of drug resistance and the ongoing advancement of related fields both domestically and internationally, academic understanding of drug resistance has gradually deepened. This review is grounded in the TCM theoretical framework of “excess and deficiency pathogenesis,” systematically organizing the TCM etiology and pathogenesis of drug resistance, with a focus on elucidating the key roles of the imbalance between “cancer toxins” and “vital energy” in the onset and progression of drug resistance. Concurrently, drawing upon the TCM therapeutic principle of simultaneously “tonifying the healthy qi” and “expelling pathogenic factors,” this review further explores how TCM can improve the pathological states of “excessive cancer toxins” and “deficient healthy qi” through multi-target regulation and multi-pathway intervention. This approach aims to reverse or delay tumor drug resistance, thereby providing theoretical support and practical solutions with distinctive TCM characteristics for addressing the clinical challenges of tumor drug resistance.