Primary hepatic carcinoma (PHC) represents a significant global public health challenge, characterized by high morbidity and mortality rates. The disease burden is particularly pronounced in China and globally. The etiology of PHC is multifaceted, involving various pathogenic factors such as aflatoxin exposure, alcohol abuse, viral infections, and others. According to Traditional Chinese Medicine (TCM), PHC can be categorized under ganji (liver accumulation) and jiju (accumulation-gathering), with its pathogenesis closely linked to emotional damages, contraction of exogenous pathogenic toxins, improper diet, insect poisons, phlegm stasis, blood stasis, and deficiency of vital qi. Drawing on the accumulation syndrome theory from the Huangdi Neijing (Yellow Emperor’s Inner Canon) and the concept of "dredging collaterals" from the study of collateral diseases, Professor Sun Zhiwei’s team proposed that the core pathogenesis of PHC is "collateral-qi stagnation" . This condition is marked by the stagnation of collateral-qi, leading to healthy qi deficiency and toxin aggregation. Specifically, qi stagnation transforms into toxin accumulation; collaterals become blocked, resulting in prolonged cancer toxin accumulation. Treatment primarily focuses on enhancing qi to unblock collaterals, promoting qi flow to clear collaterals, eliminating phlegm to unblock collaterals, and removing blood stasis to unblock collaterals. The ultimate goal is to reinforce healthy qi, dissolve accumulations, eliminate cancerous toxins, and promote blood circulation thereby achieving the goal of expelling pathogens to restore harmony. This approach seeks to deepen the application of accumulation pathology theory in PHC and other refractory diseases, offering novel perspectives and strategies for clinical application.

primary liver cancer;accumulation syndrome theory;the method of dredging collaterals;TCM treatment;theoretical discussion