北京市名老中医治疗肺癌的经验总结与临床研究
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摘要
随着我国积极推动名老中医学术经验的传承计划,近年来与名医治验相关的研究百花齐放,让后学者眼花撩乱,无所适从。北京是我国首都,亦是中医学术交流与争鸣的重要城市、孕育名医的摇篮,在中医药发展具领导地位。在治疗肺癌的领域上,北京医家们既有学术互通之处,也有不同的临床绝技。本文收集多位具代表性的名老中医的临证经验,归纳他们的共同特色,并在此基础上挖掘各家的用药特色,藉以有效提炼现今北京市治疗肺癌常用中药的普遍性和特色性。由于普遍性用药经长时间验证,疗效确切,安全性高；特色性用药则为后学者开拓思路,有利于中医药的发展,所以,本研究对中医药治疗肺癌的发展有着重大的意义。
本研究透过传统基础理论的应用,以及临床文献和信息分析的研究方法,系统整理过往研究中散在的经验和成果。同时,通过本人临床跟师,总结蕴含于临床医案中显性和隐性的知识和经验,以期有效而全面的展示北京市内五位于中医肿瘤界最具权威性的名老中医治疗肺癌的临证经验,他们包括：张代钊教授、郁仁存教授、朴炳奎教授、孙桂芝教授和李佩文教授。并以此为基础,总结出北京市名老中医治疗肺癌的整体方向,以及各位老中医辨治肺癌的用药特色。
本文的主体由四部分组成,包括：中西医结合防治肿瘤的起源与发展；北京市名老中医治疗肺癌的概述；基于信息挖掘技术的北京市名老中医治疗肺癌经验总结；以及北京市名老中医治疗肺癌常见转移性病变的经验。
第一部分：中西医结合防治肿瘤的起源与发展,通过搜集和整理各名老中医以及其门人过往发表的文章,概述北京市中医肿瘤学科的发展过程,当中包括北京三所著名医院(中国中医科学院广安门医院、首都医科大学附属医院北京中医医院、卫生部中日友好医院)中医肿瘤科成立的经过,同时介绍五位老中医对中医、中西医结合肿瘤学的发展的贡献、并剖析了诸位对中西医结合临床应用的要素与技巧的见解。
第二部分：北京市名老中医治疗肺癌经验的概述,通过参阅诸位专家的著作和老中医们在笔者侍诊一年半里所作的言传身教,深入发掘各位老中医对肺癌病因病机、常见证候、遣方用药的认识。综合各家观点,得出北京市运用中医药治疗肺癌的具体方向。在病因病机方面,诸家认为肺癌患者多有虚实两面,但以虚为主；常见证候方面,总结出五种肺癌常见证型,包括：肺阴虚型；肺脾两虚、痰湿蕴肺型；肺肾两虚型；气血瘀滞型；气血双亏型。遣方用药方面,总结了多种肺癌常用的治疗法则,包括：益气健脾法；滋补肝肾法；宣降肺气法；润肺生津法；化痰散结法；活血通络法；清热解毒法；以及和胃消食法。
等三部分：基于信息挖掘技术的北京市著名老中医治疗肺癌经验总结,通过利用复杂网络分析法,将笔者自2011年6月至2013年2月期间,跟随各位老中医出诊所收集的治疗肺癌的门诊处方各120张(共600张)进行分析,得出了北京市名老中医治疗肺癌的核心处方(北京市核心方),以及各老中医治疗肺癌的核心处方。前者由生黄芪、太子参、鸡血藤、陈皮、浙贝、鸡内金、焦神曲、焦麦芽、焦山楂、砂仁、龙葵、白花蛇舌草、草河车、女贞子、枸杞子组成,若以以方测证,可分析出北京市名老中医们认为肺癌的本质,是脾肾两虚,痰、瘀、毒互结。若按药物功效归类,核心处方各治疗原则(益气-活血-散结-解毒-补肾-和胃)的比例是2-1-1-3-2-5。按百分率计算,即益气占全方的13.34%、活血占全方的6.67%、散结占全方的6.67%、解毒占全方20%、补肾占全方的13.34%、和胃占全方的33.34%。若以益气、补肾、和胃归为扶正类,而活血、散结、解毒归为祛邪类,扶正-祛邪的比例为3：2。按百分率计算,即扶正占全方的60%,祛邪占全方的40%。可见核心处方的治疗原则以扶正为主、祛邪为辅。扶正以和胃为主,其次为益气和补肾；祛邪以解毒为主、其次为活血和散结。
本文亦通过核心处方之间的比对,分析出各老中医治疗肺癌的特色。
张代钊教授治疗肺癌的核心处方的治疗原则是以扶正为主,祛邪为辅。与北京市核心处方比较,明显重于扶正,扶正中又以健脾为主,其次为和胃、滋阴,再其次为益气。
郁仁存教授治疗肺癌的核心处方的治疗原则是以扶正为主,祛邪为辅。与北京市核心方处比较,配伍原则比较相似。
朴炳奎教授治疗肺癌的核心处方的治疗原则是以扶正为主,祛邪为辅。与北京市核心处方比较,明显重于扶正,扶正又以和胃为主、其次为益气和补肾、再其次为健脾。
孙桂芝教授治疗肺癌的核心处方的治疗原则是以扶正与祛邪并重。与北京市核心处方比较,祛邪于处方中的百分比略为增加,扶正于处方内的百分比相对减少。祛邪之中又以活血通络为主、其次为化痰散结、再其次为清热解毒。而扶正方面则以滋阴为主,其次为益气、补肾和健脾。
李佩文教授治疗肺癌的核心处方的治疗原则是以祛邪为主,扶正为辅。与北京市核心处方比较,增加了祛邪于处方中的百分比,而减少了扶正于处方内的百分比。祛邪之中又以解毒为主、其次为止咳和散结。
此外又通过利用点式互信息法挖掘出各位老中医在肺癌结合西医治疗的不同阶段(包括：纯中医治疗、手术过后、化疗阶段、靶向治疗阶段)和常见转移病变(包括：脑转移、肝转移、骨转移、胸腔积液)的用药规律。
第四部分：北京市名老中医治疗肺癌常见转移性病变的经验,通过归纳总结各位老中医的临证病历,深入探讨诸位专家在治疗肺癌常见转移病变的临证思路与用药特色。
综合上述内容,本文全面地总结了北京市名老中医防治肺癌的整体方向,并对各位老中医治疗肺癌,以及常见转移病变的临证经验作出了深入的研究,为中医肿瘤学理论研究提供新思路,并充实和丰富了中医肿瘤学说的理论内涵。
A growing number of studies on the diagnostic and treatment methods advocated by different distinguished Chinese medicine practitioners have been observed in recent years with the zealous promotion of the project on academic inheritance of the eminent and experienced Chinese medicine practitioner in China. This results in the blossoming of the field of Chinese medicine, but at the same time, the diverse views and emergence of new thoughts lead to confusion to the young scholars. Beijing, as the capital of China, takes up a leading position in the development of Chinese medicine. It is the city that nurtures a large number of distinguished Chinese medicine practitioners and provides a favourable platform for academic exchange. These distinguished Chinese medicine practitioners have adopted different clinical solutions while sharing some of the academic philosophies in the area of lung cancer treatment. This study seeks to identify the commonalities and distinctiveness in lung cancer medication with traditional Chinese medicine in Beijing by analysing the clinical experiences, generalising the common clinical practices and synthesising the medication characteristic among various representable and experienced Chinese medicine practitioners. Commonalities in medication assure high level of drug safety and treatment effectiveness since the agreeable way of medication has been validated over time. On the other hand, distinctiveness in medication is thought-provoking which will be beneficial to the overall development of traditional Chinese medicine. By generalising the commonalities and distinctiveness in the medication, it is anticipated that this study would facilitate the development of lung cancer treatment with the application of Chinese medicine.
This study systematically collates the scattered findings and experiences shared in previous researches through theory application, literature review and statistical analysis. The author summarises the knowledge and experience gained from the clinical cases in his clinical apprentice, with the aim of comprehensively revealing the clinical experiences on lung cancer treatment of the five most prestigious and experienced Chinese medicine practitioners in oncology in Beijing, including Prof. ZHANG Dai-zhao, Prof. YU Ren-cun, Prof. PIAO Bing-kui, Prof. SUN Gui-zhi and Prof. LI Pei-wen, and thereby identifies the overall direction in lung cancer treatment in Beijing and also the medication characteristics of the aforementioned Chinese medicine practitioners.
The main body of this paper is composed of four parts, including (i) The Origin and Development of Integrative Medicine on Cancer Prevention and Treatment;(ii) Introduction on the Treatment Plan of Lung Cancer among Eminent and Experienced Chinese Medicine Practitioners in Beijing;(ⅲ) Statistical Analysis on the Lung Cancer Treatment Experience of Five Eminent and Experience Chinese Medicine Practitioners in Beijing; and (ⅳ) Treatment Experience on Metastatic Disease Induced by Lung Cancer among the Eminent and Experience Chinese Medicine Practitioners in Beijing.
The first part:The Origin and Development of Integrative Medicine on Cancer Prevention and Treatment introduces the development of oncology in the field of Chinese medicine in Beijing through reviewing and synthesising the papers published by the five Chinese medicine practitioners and their apprentices. This includes the establishment of the department of oncology in three reputable hospitals in Beijing (Guanganmen Hospital, China Academy of Chinese Medical Science; Beijing Hospital of Traditional Chinese Medicine, CPUMS and China-Japan Friendship Hospital). This chapter also introduces the contributions of the five Chinese medicine practitioners to the field of traditional Chinese medicine and in the development of integrative medicine in oncology, and also analyses their clinical application of integrative medicine.
The second part:Introduction on the Treatment Plan of Lung Cancer among Eminent and Experienced Chinese Medicine Practitioners in Beijing is written based on the insight gained from reviewing the publications of the five Chinese medicine practitioners and their face-to-face experience sharing during the author's1.5-year clinical practice. This chapter generalises the overall direction in lung cancer treatment with the application of Chinese medicine in Beijing by looking into the views and experiences of the five Chinese medicine practitioners on the etiology and pathology, common syndromes and prescription in lung cancer treatment. For etiology and pathology, these Chinese medicine practitioners consider that both vacuity and repletion would be observed from lung cancer patients while vacuity prevails. The five common types of lung cancer syndromes identified include yang deficiency of lung; deficiency of both lung and spleen and also phlegm retention in lung; deficiency of both lung and kidney; static Qi and blood; and exhaustion of both Qi and blood. The common principles on prescription include invigorating spleen and replenishing Qi; nourishing liver and kidney; dispersing and expelling Qi in lung; nourishing lung to relieve dryness; dissipating phlegm and dispelling clots; promoting blood circulation for dredging collaterals; heat clearance and detoxification; and regulating stomach to facilitate digestion.
The third part:Statistical Analysis on the Lung Cancer Treatment Experience of Five Eminent and Experience Chinese Medicine Practitioners in Beijing is the summary result by complex network analysis on120prescriptions for treating lung cancer of each of the five Chinese medicine practitioners (600prescriptions in total) collected by the author during his clinical apprentice between June2011to February2013. This chapter captures both the general core prescription on treating lung cancer among Chinese medicine practitioners in Beijing and the core prescription of individual Chinese medicine practitioner. The general core prescription is composed of Raw Astragalus, Heterophylly Falsetarwort Root, Suberect Spatholobus Stem, Dried Tangerine Peel, Zhebei, Chicken Gizzard Skin, Medicated Leaven, Focal Malt, Focal Hawthorn, Villous Amomum, Black Nightshade Herb, Spreading Hedyotis Herb, Rhizoma Paridis, Glossy Privet Fruit and Barbary Wolfberry Fruit. As deduced from the prescription, the five Chinese medicine practitioners considered the origin of lung cancer is deficiency of both spleen and kidney and also the conglomeration of phlegm-blood stasis-toxins. Basically, the treatment principle is replenishing Qi-promoting blood circulation-dispelling clots-detoxification-nourishing kidney-regulating stomach at the ratio2-1-1-3-2-5. By percentage, the composition is as follows:13.34%replenishing Qi,6.67%promoting blood circulation,6.67%dispelling clots,20%detoxification,13.34%nourishing kidney and33.34%regulating stomach. To further classify replenishing Qi, nourishing kidney and regulating stomach into the category of strengthening body resistance while promoting blood circulation, dispelling clots and detoxification into the category of eliminating pathogenic factors, the ratio between strengthening body resistance and eliminating pathogenic factors is3:2. This also denotes medication for strengthening body resistance and for eliminating pathogenic factors by percentage at60%and40%respectively. In sum, the basic treatment principle of lung cancer is primarily by strengthening body resistance, supplemented by the elimination of pathogenic factors, in which regulating stomach supplemented by replenishing Qi and nourishing kidney is the means of strengthening body resistance while detoxification supplemented by promoting blood circulation and dispelling clots is the means of eliminating pathogenic factors.
The paper also analyses the characteristics of the five Chinese medicine practitioners in treating lung cancer by comparing their core prescriptions.
As reflected from the prescription, the treatment principle of Prof. ZHANG Dai-zhao on lung cancer is primarily by strengthening body resistance, supplemented with the elimination of pathogenic factors. When comparing with the common core prescription in Beijing, Prof. Zhang obviously lays more emphasis on strengthening body resistance primary by invigorating spleen, followed by regulating stomach and nourishing Yang, and then by replenishing Qi.
The treatment principle of Prof. YU Ren-cun on lung cancer is primarily by strengthening body resistance, supplemented with the elimination of pathogenic factors. The principle of compatibility in prescription of Prof. Yu is relatively more similar to that of in Beijing as a whole.
The treatment principle of Prof. PIAO Bing-kui on lung cancer is primarily by strengthening body resistance, supplemented with the elimination of pathogenic factors. When comparing with the common core prescription in Beijing, the prescription of Prof. PIAO lays more emphasis on strengthening body resistance while regulating stomach takes on the most important role, followed by replenishing Qi and nourishing kidney, and then by invigorating spleen.
Strengthening body resistance and eliminating pathogenic factors are of equal weighting according to Prof. SUN Gui-zhi's treatment principle on lung cancer. When comparing with the common core prescription in Beijing, a higher percentage of Prof. SUN's prescription is for eliminating pathogenic factors while a lower percentage is for strengthening body resistance. For eliminating pathogenic factors, promoting blood circulation for dredging collaterals takes on the most important role, followed by dissipating phlegm and dispelling clots, and then by heat clearance and detoxification. Strengthening body resistance is primarily by nourishing Yang, followed by replenishing Qi, nourishing kidney and invigorating spleen.
The treatment principle of Prof. LI Pei-wen is primarily by eliminating pathogenic factors, supplemented with strengthening body resistance. When comparing with the common core prescription in Beijing, a higher percentage of Prof. LI's prescription is for eliminating pathogenic factors while a lower percentage is for strengthening body resistance. Eliminating pathogenic factors is mainly by detoxification, followed by suppressing cough and dispelling clots.
By adopting pointwise mutual information, PMI, this paper looks into the medication pattern with the application of integrative medicine on different developmental stages of lung cancer (including treatment solely by Chinese medicine, post-surgery stage, chemotherapy stage and targeted therapy stage) and the common matastatic diseases (including brain metastases, liver metastases, skeletal metastases and pleural effusion) among the five Chinese medicine practitioners.
The fourth part:Treatment Experience on Metastatic Disease Induced by Lung Cancer among the Eminent and Experience Chinese Medicine Practitioners in Beijing examines the clinical analysis and medication characteristics on the common matastatic diseases of lung cancers among the five Chinese medicine practitioners through analysing their clinical medical records.
To sum up, this paper comprehensively generalises the overall direction in lung cancer treatment with the application of Chinese medicine among the eminent and experienced Chinese medicine practitioners in Beijing. It also provides an analysis on lung cancer treatment and the clinical experience on the common matastatic diseases of lung cancers among these Chinese medicine practitioners with ample breadth and depth. It is anticipated that this study would shed light on the further development of research on oncology in the field of traditional Chinese medicine.
本研究透过传统基础理论的应用,以及临床文献和信息分析的研究方法,系统整理过往研究中散在的经验和成果。同时,通过本人临床跟师,总结蕴含于临床医案中显性和隐性的知识和经验,以期有效而全面的展示北京市内五位于中医肿瘤界最具权威性的名老中医治疗肺癌的临证经验,他们包括：张代钊教授、郁仁存教授、朴炳奎教授、孙桂芝教授和李佩文教授。并以此为基础,总结出北京市名老中医治疗肺癌的整体方向,以及各位老中医辨治肺癌的用药特色。
本文的主体由四部分组成,包括：中西医结合防治肿瘤的起源与发展；北京市名老中医治疗肺癌的概述；基于信息挖掘技术的北京市名老中医治疗肺癌经验总结；以及北京市名老中医治疗肺癌常见转移性病变的经验。
第一部分：中西医结合防治肿瘤的起源与发展,通过搜集和整理各名老中医以及其门人过往发表的文章,概述北京市中医肿瘤学科的发展过程,当中包括北京三所著名医院(中国中医科学院广安门医院、首都医科大学附属医院北京中医医院、卫生部中日友好医院)中医肿瘤科成立的经过,同时介绍五位老中医对中医、中西医结合肿瘤学的发展的贡献、并剖析了诸位对中西医结合临床应用的要素与技巧的见解。
第二部分：北京市名老中医治疗肺癌经验的概述,通过参阅诸位专家的著作和老中医们在笔者侍诊一年半里所作的言传身教,深入发掘各位老中医对肺癌病因病机、常见证候、遣方用药的认识。综合各家观点,得出北京市运用中医药治疗肺癌的具体方向。在病因病机方面,诸家认为肺癌患者多有虚实两面,但以虚为主；常见证候方面,总结出五种肺癌常见证型,包括：肺阴虚型；肺脾两虚、痰湿蕴肺型；肺肾两虚型；气血瘀滞型；气血双亏型。遣方用药方面,总结了多种肺癌常用的治疗法则,包括：益气健脾法；滋补肝肾法；宣降肺气法；润肺生津法；化痰散结法；活血通络法；清热解毒法；以及和胃消食法。
等三部分：基于信息挖掘技术的北京市著名老中医治疗肺癌经验总结,通过利用复杂网络分析法,将笔者自2011年6月至2013年2月期间,跟随各位老中医出诊所收集的治疗肺癌的门诊处方各120张(共600张)进行分析,得出了北京市名老中医治疗肺癌的核心处方(北京市核心方),以及各老中医治疗肺癌的核心处方。前者由生黄芪、太子参、鸡血藤、陈皮、浙贝、鸡内金、焦神曲、焦麦芽、焦山楂、砂仁、龙葵、白花蛇舌草、草河车、女贞子、枸杞子组成,若以以方测证,可分析出北京市名老中医们认为肺癌的本质,是脾肾两虚,痰、瘀、毒互结。若按药物功效归类,核心处方各治疗原则(益气-活血-散结-解毒-补肾-和胃)的比例是2-1-1-3-2-5。按百分率计算,即益气占全方的13.34%、活血占全方的6.67%、散结占全方的6.67%、解毒占全方20%、补肾占全方的13.34%、和胃占全方的33.34%。若以益气、补肾、和胃归为扶正类,而活血、散结、解毒归为祛邪类,扶正-祛邪的比例为3：2。按百分率计算,即扶正占全方的60%,祛邪占全方的40%。可见核心处方的治疗原则以扶正为主、祛邪为辅。扶正以和胃为主,其次为益气和补肾；祛邪以解毒为主、其次为活血和散结。
本文亦通过核心处方之间的比对,分析出各老中医治疗肺癌的特色。
张代钊教授治疗肺癌的核心处方的治疗原则是以扶正为主,祛邪为辅。与北京市核心处方比较,明显重于扶正,扶正中又以健脾为主,其次为和胃、滋阴,再其次为益气。
郁仁存教授治疗肺癌的核心处方的治疗原则是以扶正为主,祛邪为辅。与北京市核心方处比较,配伍原则比较相似。
朴炳奎教授治疗肺癌的核心处方的治疗原则是以扶正为主,祛邪为辅。与北京市核心处方比较,明显重于扶正,扶正又以和胃为主、其次为益气和补肾、再其次为健脾。
孙桂芝教授治疗肺癌的核心处方的治疗原则是以扶正与祛邪并重。与北京市核心处方比较,祛邪于处方中的百分比略为增加,扶正于处方内的百分比相对减少。祛邪之中又以活血通络为主、其次为化痰散结、再其次为清热解毒。而扶正方面则以滋阴为主,其次为益气、补肾和健脾。
李佩文教授治疗肺癌的核心处方的治疗原则是以祛邪为主,扶正为辅。与北京市核心处方比较,增加了祛邪于处方中的百分比,而减少了扶正于处方内的百分比。祛邪之中又以解毒为主、其次为止咳和散结。
此外又通过利用点式互信息法挖掘出各位老中医在肺癌结合西医治疗的不同阶段(包括：纯中医治疗、手术过后、化疗阶段、靶向治疗阶段)和常见转移病变(包括：脑转移、肝转移、骨转移、胸腔积液)的用药规律。
第四部分：北京市名老中医治疗肺癌常见转移性病变的经验,通过归纳总结各位老中医的临证病历,深入探讨诸位专家在治疗肺癌常见转移病变的临证思路与用药特色。
综合上述内容,本文全面地总结了北京市名老中医防治肺癌的整体方向,并对各位老中医治疗肺癌,以及常见转移病变的临证经验作出了深入的研究,为中医肿瘤学理论研究提供新思路,并充实和丰富了中医肿瘤学说的理论内涵。
A growing number of studies on the diagnostic and treatment methods advocated by different distinguished Chinese medicine practitioners have been observed in recent years with the zealous promotion of the project on academic inheritance of the eminent and experienced Chinese medicine practitioner in China. This results in the blossoming of the field of Chinese medicine, but at the same time, the diverse views and emergence of new thoughts lead to confusion to the young scholars. Beijing, as the capital of China, takes up a leading position in the development of Chinese medicine. It is the city that nurtures a large number of distinguished Chinese medicine practitioners and provides a favourable platform for academic exchange. These distinguished Chinese medicine practitioners have adopted different clinical solutions while sharing some of the academic philosophies in the area of lung cancer treatment. This study seeks to identify the commonalities and distinctiveness in lung cancer medication with traditional Chinese medicine in Beijing by analysing the clinical experiences, generalising the common clinical practices and synthesising the medication characteristic among various representable and experienced Chinese medicine practitioners. Commonalities in medication assure high level of drug safety and treatment effectiveness since the agreeable way of medication has been validated over time. On the other hand, distinctiveness in medication is thought-provoking which will be beneficial to the overall development of traditional Chinese medicine. By generalising the commonalities and distinctiveness in the medication, it is anticipated that this study would facilitate the development of lung cancer treatment with the application of Chinese medicine.
This study systematically collates the scattered findings and experiences shared in previous researches through theory application, literature review and statistical analysis. The author summarises the knowledge and experience gained from the clinical cases in his clinical apprentice, with the aim of comprehensively revealing the clinical experiences on lung cancer treatment of the five most prestigious and experienced Chinese medicine practitioners in oncology in Beijing, including Prof. ZHANG Dai-zhao, Prof. YU Ren-cun, Prof. PIAO Bing-kui, Prof. SUN Gui-zhi and Prof. LI Pei-wen, and thereby identifies the overall direction in lung cancer treatment in Beijing and also the medication characteristics of the aforementioned Chinese medicine practitioners.
The main body of this paper is composed of four parts, including (i) The Origin and Development of Integrative Medicine on Cancer Prevention and Treatment;(ii) Introduction on the Treatment Plan of Lung Cancer among Eminent and Experienced Chinese Medicine Practitioners in Beijing;(ⅲ) Statistical Analysis on the Lung Cancer Treatment Experience of Five Eminent and Experience Chinese Medicine Practitioners in Beijing; and (ⅳ) Treatment Experience on Metastatic Disease Induced by Lung Cancer among the Eminent and Experience Chinese Medicine Practitioners in Beijing.
The first part:The Origin and Development of Integrative Medicine on Cancer Prevention and Treatment introduces the development of oncology in the field of Chinese medicine in Beijing through reviewing and synthesising the papers published by the five Chinese medicine practitioners and their apprentices. This includes the establishment of the department of oncology in three reputable hospitals in Beijing (Guanganmen Hospital, China Academy of Chinese Medical Science; Beijing Hospital of Traditional Chinese Medicine, CPUMS and China-Japan Friendship Hospital). This chapter also introduces the contributions of the five Chinese medicine practitioners to the field of traditional Chinese medicine and in the development of integrative medicine in oncology, and also analyses their clinical application of integrative medicine.
The second part:Introduction on the Treatment Plan of Lung Cancer among Eminent and Experienced Chinese Medicine Practitioners in Beijing is written based on the insight gained from reviewing the publications of the five Chinese medicine practitioners and their face-to-face experience sharing during the author's1.5-year clinical practice. This chapter generalises the overall direction in lung cancer treatment with the application of Chinese medicine in Beijing by looking into the views and experiences of the five Chinese medicine practitioners on the etiology and pathology, common syndromes and prescription in lung cancer treatment. For etiology and pathology, these Chinese medicine practitioners consider that both vacuity and repletion would be observed from lung cancer patients while vacuity prevails. The five common types of lung cancer syndromes identified include yang deficiency of lung; deficiency of both lung and spleen and also phlegm retention in lung; deficiency of both lung and kidney; static Qi and blood; and exhaustion of both Qi and blood. The common principles on prescription include invigorating spleen and replenishing Qi; nourishing liver and kidney; dispersing and expelling Qi in lung; nourishing lung to relieve dryness; dissipating phlegm and dispelling clots; promoting blood circulation for dredging collaterals; heat clearance and detoxification; and regulating stomach to facilitate digestion.
The third part:Statistical Analysis on the Lung Cancer Treatment Experience of Five Eminent and Experience Chinese Medicine Practitioners in Beijing is the summary result by complex network analysis on120prescriptions for treating lung cancer of each of the five Chinese medicine practitioners (600prescriptions in total) collected by the author during his clinical apprentice between June2011to February2013. This chapter captures both the general core prescription on treating lung cancer among Chinese medicine practitioners in Beijing and the core prescription of individual Chinese medicine practitioner. The general core prescription is composed of Raw Astragalus, Heterophylly Falsetarwort Root, Suberect Spatholobus Stem, Dried Tangerine Peel, Zhebei, Chicken Gizzard Skin, Medicated Leaven, Focal Malt, Focal Hawthorn, Villous Amomum, Black Nightshade Herb, Spreading Hedyotis Herb, Rhizoma Paridis, Glossy Privet Fruit and Barbary Wolfberry Fruit. As deduced from the prescription, the five Chinese medicine practitioners considered the origin of lung cancer is deficiency of both spleen and kidney and also the conglomeration of phlegm-blood stasis-toxins. Basically, the treatment principle is replenishing Qi-promoting blood circulation-dispelling clots-detoxification-nourishing kidney-regulating stomach at the ratio2-1-1-3-2-5. By percentage, the composition is as follows:13.34%replenishing Qi,6.67%promoting blood circulation,6.67%dispelling clots,20%detoxification,13.34%nourishing kidney and33.34%regulating stomach. To further classify replenishing Qi, nourishing kidney and regulating stomach into the category of strengthening body resistance while promoting blood circulation, dispelling clots and detoxification into the category of eliminating pathogenic factors, the ratio between strengthening body resistance and eliminating pathogenic factors is3:2. This also denotes medication for strengthening body resistance and for eliminating pathogenic factors by percentage at60%and40%respectively. In sum, the basic treatment principle of lung cancer is primarily by strengthening body resistance, supplemented by the elimination of pathogenic factors, in which regulating stomach supplemented by replenishing Qi and nourishing kidney is the means of strengthening body resistance while detoxification supplemented by promoting blood circulation and dispelling clots is the means of eliminating pathogenic factors.
The paper also analyses the characteristics of the five Chinese medicine practitioners in treating lung cancer by comparing their core prescriptions.
As reflected from the prescription, the treatment principle of Prof. ZHANG Dai-zhao on lung cancer is primarily by strengthening body resistance, supplemented with the elimination of pathogenic factors. When comparing with the common core prescription in Beijing, Prof. Zhang obviously lays more emphasis on strengthening body resistance primary by invigorating spleen, followed by regulating stomach and nourishing Yang, and then by replenishing Qi.
The treatment principle of Prof. YU Ren-cun on lung cancer is primarily by strengthening body resistance, supplemented with the elimination of pathogenic factors. The principle of compatibility in prescription of Prof. Yu is relatively more similar to that of in Beijing as a whole.
The treatment principle of Prof. PIAO Bing-kui on lung cancer is primarily by strengthening body resistance, supplemented with the elimination of pathogenic factors. When comparing with the common core prescription in Beijing, the prescription of Prof. PIAO lays more emphasis on strengthening body resistance while regulating stomach takes on the most important role, followed by replenishing Qi and nourishing kidney, and then by invigorating spleen.
Strengthening body resistance and eliminating pathogenic factors are of equal weighting according to Prof. SUN Gui-zhi's treatment principle on lung cancer. When comparing with the common core prescription in Beijing, a higher percentage of Prof. SUN's prescription is for eliminating pathogenic factors while a lower percentage is for strengthening body resistance. For eliminating pathogenic factors, promoting blood circulation for dredging collaterals takes on the most important role, followed by dissipating phlegm and dispelling clots, and then by heat clearance and detoxification. Strengthening body resistance is primarily by nourishing Yang, followed by replenishing Qi, nourishing kidney and invigorating spleen.
The treatment principle of Prof. LI Pei-wen is primarily by eliminating pathogenic factors, supplemented with strengthening body resistance. When comparing with the common core prescription in Beijing, a higher percentage of Prof. LI's prescription is for eliminating pathogenic factors while a lower percentage is for strengthening body resistance. Eliminating pathogenic factors is mainly by detoxification, followed by suppressing cough and dispelling clots.
By adopting pointwise mutual information, PMI, this paper looks into the medication pattern with the application of integrative medicine on different developmental stages of lung cancer (including treatment solely by Chinese medicine, post-surgery stage, chemotherapy stage and targeted therapy stage) and the common matastatic diseases (including brain metastases, liver metastases, skeletal metastases and pleural effusion) among the five Chinese medicine practitioners.
The fourth part:Treatment Experience on Metastatic Disease Induced by Lung Cancer among the Eminent and Experience Chinese Medicine Practitioners in Beijing examines the clinical analysis and medication characteristics on the common matastatic diseases of lung cancers among the five Chinese medicine practitioners through analysing their clinical medical records.
To sum up, this paper comprehensively generalises the overall direction in lung cancer treatment with the application of Chinese medicine among the eminent and experienced Chinese medicine practitioners in Beijing. It also provides an analysis on lung cancer treatment and the clinical experience on the common matastatic diseases of lung cancers among these Chinese medicine practitioners with ample breadth and depth. It is anticipated that this study would shed light on the further development of research on oncology in the field of traditional Chinese medicine.
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