摘要
肿瘤患者常伴有局部淋巴结或远处淋巴结的转移,其本质为虚,同时具有痰、瘀、毒的特点。一些特定部位的淋巴结转移可引起相关并发症,如上腔静脉综合征、食管-贲门不完全梗阻、转移性淋巴结破溃等。故临床治疗应以补虚为主,兼顾祛邪。上腔静脉综合征多为脾肾阳虚,故治宜通阳利水或温肾行水,药用泽兰、蜜炙麻黄、桂枝、羌活、防己等;食管-贲门不完全梗阻的症状类似于"梅核气"的表现,应以四君子汤或参苓白术散为基础加减,同时因其多挟痰、挟湿,故治宜健脾化湿、和胃降逆,药用旋复花、石决明、青礞石、竹茹等;浅表淋巴结的破溃以"癌毒"为主要病因,故治宜"以毒攻毒",药如蜈蚣、全蝎、地龙等,同时临床可根据局部症状的表现,灵活选用散剂以外治,忌用破血逐瘀之品,恐助"癌毒"流串。
Tumor patients often suffer from metastasis of regional lymph nodes or distant lymph nodes. Their nature of the condition is deficiency,and they are also characterized by the pathological factors such as phlegm,stasis,and toxin. Lymph node metastases at specific sites can cause complications such as superior vena cava syndrome,incomplete esophageal-cardiac obstruction,and metastatic lymph node rupture. Therefore,clinical treatment should mainly deal with the deficiency with dispelling the above mentioned evils as the secondary consideration. The main characteristic of the vena cava syndrome is Spleen and Kidney Yang Deficiency,so the treatment should tonify Yang to remove Water or warm Kidney Yang to drive Water. Medicinal like Zeeland,Honey ephedra,Guizhi,Loquat Hu,Fangji,etc. are usually used. The esophageal-cardiac incomplete obstruction symptoms are similar to that of ＂ Mexu Qi＂,which should be cured with modified Sijunzi Decoction or Shenqibaishu Powder. Besides,because of the factors of phlegm and Dampness,tonifying Spleen to remove Dampness should be the treatment principle as well as harmonizing stomach and lowering the adverse Qi. The medicinal includes Inula flower,Stone cassia,Barley stone,Zhuru,etc. The superficial lymph node ulceration is mainly caused by cancer toxin,so it is appropriate to ＂ like cures like＂,medicine such as Wolfberry,Scorpion,Earthworm,etc. are usually used. In addition,according to the performance of local symptoms,medical powder can be used flexibly outside the skin. Avoid the use of medicine that dispels the blood stasis for fear of ＂ cancer＂ spreading.
作者
徐晓卿
张盈盈
齐元富
XU Xiaoqing;ZHANG Yingying;QI Yuanfu(The Affiliated Hospital to Shandong University of Traditional Chinese Medicine,Jinan Shandong China 250011;Shandong University of Traditional Chinese Medicine, Jinan Shandong China 250355)
出处
《中医学报》
CAS
2018年第5期716-718,共3页
Acta Chinese Medicine
关键词
淋巴结转移相关并发症
肿瘤
上腔静脉综合征
食管-贲门不完全梗阻
转移性淋巴结破溃
齐元富
Lymph node metastasis-related complications
Neoplasms
Superior vena cava syndrome
incomplete esophageal-cardial obstruction
Metastatic metastatic lymph nodes
Qi Yuanfu
