摘要
恶性肿瘤为正虚邪毒内蕴,肺癌虚证有气阴两虚、肺脾气虚、阴阳两虚;实证有痰湿阻肺、痰热蕴肺、气滞血瘀多为本虚标实,虚实夹杂或数种证型兼杂;初发实证居多,虚证不显;治疗分扶正祛邪两类,扶正常用益气养阴、健脾补肺、益气养血、滋阴温阳等补法,祛邪常用化痰利湿、活血化瘀、清热解毒等治法;分清虚实主次,辨别邪正盛衰,立足扶正祛邪并施,力争以扶正来祛邪,以祛邪来扶正,做到祛邪而不伤正,扶正而不助邪;不可盲目重用有毒峻猛攻逐药物,企图尽快消除肿瘤,势必耗气伤阴,甚至苦寒败胃,损伤正气,造成后续治疗困难;也不可一味扶正补益,不用攻邪药物控制和减缓肿瘤发展,肿瘤得以加速生长。只有辨证精确,用药适当,方能取得良好的效果。中西医结合治疗肺癌要从四个方面着手:辨证论治,分析症状、舌苔、脉象等,根据不同证型选择用药;辨病论治,结合现代医学,明确肿瘤分期,西医治疗及理化检查等,选择相关中药;结合现代中药药理研究,准确揭示药物作用主要成分,有效弥补辨病和辨证不足;参考临床报道和名家经验,有利拓展个人的临床施治思维,整体和局部治疗结合,宏观和微观治疗统一,选择有效抗肿瘤措施,制定治疗方案,提高临床疗效。附肺腺癌(气阴亏虚,瘀痰互结)验案1则。
The pathogenesis of malignant tumor is lingering pathogen due to deficient vital Qi. The deficient syndrome of lung cancer includes Qi and Yin deficiency, spleen and lung deficiency, Yin and Yang deficiency. The excess syndrome includes phlegm dampness in the lung, phlegm-heat obstructing lung, Qi stagnation and blood stasis. These syndromes are mostly deficiency in origin and excess in superficiality, deficiency and excess inclusion or multiple types of syndromes. There is more excess syndromes in the early patients, deficiency is not significant. The treatment mainly includes strengthening vital Qi and eliminate pathogenic factor. The former commonly used is replenishing qi and nourishing Yin, invigorating spleen and lung, nourishing qi and replenishing blood, nourishing Yin and warming Yang. And the latter commonly used is removing phlegm and promoting diuresis, promoting blood circulation for removing blood stasis, clearing heat- toxicity. We should distinguish between the primary or secondary, pathogenic or vital Qi in the treatment to strengthening vital qi and eliminate pathogenic factor, and make the two be synergistic effect. We should pay attention to two points in the treatment. A lot of poisonous drugs to eliminate the tumor as soon as possible is not be allowed, because this may consume qi and injure Yin and even bitter cold hurt the stomach, damage vital Qi to difficult the follow-up treatment. Simultaneously, the method of strengthening vital Qi can not be used alone in the treatment, because it may cause tumors to grow faster. In a word, only precise differentiation and proper medication can achieve good results. Four aspects need to be considered in the combination of traditional Chinese and western medicine treatment of lung cancer. Treatment based on syndrome differentiation, select drugs according to different syndromes through the analysis of symptoms, tongue and pulse. Treatment based on disease differentiation, select drugs according to tumor stage, western medicine treatment and physical a
出处
《实用中医内科杂志》
2016年第12期57-60,共4页
Journal of Practical Traditional Chinese Internal Medicine
关键词
肺癌
正虚邪毒内蕴
气阴两虚
肺脾气虚
阴阳两虚
肿瘤分期
痰湿阻肺
痰热蕴肺
气滞血瘀
本虚标实
扶正祛邪
辨证论治
辨病论治
中药药理
肺腺癌
中西医结合治疗
lung cancer
lingering pathogen due to deficient vital Qi
deficiency of both Qi and Yin
spleen and lung Qi deficiency
Yin and Yang deficiency
tumor stage
phlegm dampness in the lung
phlegmheat obstructing lung
Qi stagnation and blood stasis
intermingled deficiency and excess
strengthening vital Qi to eliminate pathogenic factor
treatment based on syndrome differentiation
treatment based on disease differentiation
traditional Chinese medicine pharmacology
lung adenocarcinoma
integrated traditional Chinese and western medicine treatment
