活血化瘀法在恶性肿瘤治疗中的应用研究
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摘要
研究目的:
瘀血的研究在传统中医学历史悠久,源远流长。“血瘀”的概念亦因此有狭义和广义之别。狭义的血瘀(瘀血)是指积血、留血、恶血、蓄血、干血、死血、败血、血液运行不畅而停滞的病理产物。广义的血瘀包括了狭义的瘀血,更泛指由痰浊、食滞、瘟疫、暑热、寒湿、情志刺激等因素导致血液流动不畅,或积于脉内,或溢于脉外,或形成血栓,以及机体性质、成分发生改变者。血瘀是许多疾病极为常见的基本病变和共同病态,对于疾病的发展转归有重要影响。有诸病多瘀、病久血瘀、瘀生湿浊、瘀阻气血、瘀久入络等特点。
传统医学认为肿瘤是一种全身性疾病而不是局部性疾病,肿块是全身性疾病的局部表现。肿瘤是一种病类而非一个病,其致病因素很复杂。病因主要为外邪侵袭、饮食所伤、正气亏虚和精神情志失调,病机为气滞血瘀、痰湿凝聚、热毒蕴结、脏腑虚损等。祖国医学认为气血瘀滞是肿瘤发病的基本病因。气血失调,气机郁滞,血行不畅,导致气滞血瘀,常表现为血瘀证。瘀结日久,又将进一步阻碍气机的运行,必成癥瘕积聚。从现代肿瘤学角度,瘀血体质的人有癌变的倾向,癌变后恶性转移率明显较高,复发率亦较高,预后欠佳,持续性血液高凝状态与癌症前期的关联早已被建立。此外肿瘤的发生、发展、转移还与凝血系统异常、新血管生成等有密切关系,因此提出在抗癌的治疗策略,活血化瘀大法的选用应考虑为各治疗法则中之必然。现代研究表明,活血化瘀在改善微循环通畅之际,亦调整与强化机体免疫功能,有助于对肿瘤的抑制,有些活血化瘀方药更可直接杀灭肿瘤细胞。
本课题旨在中医理论指导下探讨血瘀对癌症病变尤其是恶性肿瘤转移所扮演的角色。在研究过程中会重访传统中医对血瘀的概念,并从现代医学视野深入探讨活血化瘀治疗癌肿及癌前病变效应,以及其双重性与血管生成的关系。从收集和分析各名中医的抗癌效方中的药物和药对,期望提供另一个以控制恶性肿瘤转移和癌症病变的治疗选择。
研究方法:
学生从古代医学及现代医学角度通过查阅大量文献,探讨了血瘀与恶性肿瘤的关系,两者相互影响、密不可分,因此提出活血化瘀可贯穿于治疗恶性肿瘤始终,并从约256个近期中医药方剂的分析,证实活血化瘀大法已融入各种癌症的治法中,并与其他治疗大法并用。被分析的方剂或多或少都有活血化瘀中草药成分配伍;有古方加减活血化瘀药物,有活血化瘀古方、经方化裁再加针对病情的药物,亦有单味药为方,更有当代中医所新编的活血化瘀方。分析提示了几个趋势或模式,药物大剂量的使用、血中气药的广泛运用、近期方剂搜风药的普遍运用,尤在晚期癌症。通过分析这些方剂,可有助于了解活血化瘀中药的特性,从而有助于临床的运用。
研究结果:
传统医学认为气血瘀滞是肿瘤发病的基本病因,凡是癌瘤,必正气虚弱,阴阳失调,气血功能障碍,导致气滞血瘀、湿聚痰凝、火毒内盛等相互胶结的病理变化。而血瘀证形成的基本病理机制可概括为:气滞血瘀,不通则痛,血瘀而形成瘀血积聚,发为肿块而成癌瘤。现代医学发现恶性肿瘤、血液凝固、新血管生成三者关系密切。癌症微环境是创造于三种不同细胞,则癌细胞、血管细胞和宿主间质细胞的相互信息传导。持续性的“血液高凝状态”已证实对患恶性肿瘤的风险。癌细胞为了在宿主体内增殖和转移,必须与血凝系统、抗凝系统和溶纤维蛋白系统相互配合,得其援助,促进新血管生成,从而建立癌前血凝恶性循环。新血管生成是血液凝固和恶性肿瘤转移的中心环节,凝血系统的关键因子如组织因子、凝血酶和非水融性蛋白可通过凝血途径和非凝血途径而诱导新血管生成,从而滋养癌细胞的生长。在不同肿瘤的各个阶段均可见瘀血的征象,因而常施展“活血化瘀、异病同治”之手段贯穿了肿瘤治疗的始末。
活血化瘀不仅可以使瘀阻的络脉再通,疼痛缓解,亦可以通过化瘀消除癌瘤产生的病理因素,达到抑癌缩瘤、控制肿瘤发展的目的,从而解除癌痛发生的病理生理机制。现代研究证实,活血中药大多具有促流和抗凝作用,而化瘀中药大多具有抗栓溶栓作用。肿瘤分子生物学研究表明,肿瘤的形成与转移分别是癌基因与抑癌基因,肿瘤转移基因与肿瘤转移抑制基因共同作用的结果。试验研究证明活血化瘀药可以影响肿瘤细胞癌基因的表达及DNA合成的,并通过抑制血小板聚集防止瘤细胞滞留、降低纤维蛋白含量,增加纤维蛋白溶解,抑制肿瘤细胞的侵袭粘附两个途径达到抗凝目的。此外,在免疫调方面,循还系统为人体免疫功能的基础,是免疫组件的载体,气血欠佳直接影响免疫功能的素质,活血化瘀可提升人体免疫功能,防治癌变。从各种迹象,在运用活血化瘀大法治疗恶性肿瘤时应考虑到癌前血瘀的重要和优先性。抗新血管生成方面,现代研究发现,活血化瘀药有以下几个作用,从而达到抗肿瘤新血管生成的目的:①干扰血管生成因子的释放或阻断血管生成因子的作用;②抑制内皮细胞的增殖;③诱生肿瘤坏死因子(TNF)、提高TNF活性;④其他非特异性机制。
但有报导在临床上施活血化瘀大法治疗癌及癌前病变有双重性的效应,因而至今运用此大法防治癌症及恶性肿瘤转移的适应性仍被争议。学生认为主要与以下几点有关:①对无症状缺乏认识;②延误治机;③药性质量不明;④选药处方配伍疏忽;⑤忌药与方剂用药差劣。综合以上,只要有血瘀症状,原则上就可选用活血化瘀药,同时能与扶正之法并用为佳;则应在祛邪之时不伤正,扶正之余不助邪,与增强患者细胞免疫功能的中药结合使用,才能获得更好的疗效。
含有活血化瘀成份之中医抗癌方剂,来源繁多,学生从无数书籍、周刊、杂志取得近20年来256首有活血化瘀中药方剂,以脏腑分类,详细分析方中组成,在归纳法过程,观察选药的性质、剂量和在每一方剂分类中出现频率,再参考某些中药配对著作以触定配对框架,取得结论。①新编验方多以古方或经方为基础,加减组成演变而成;②验方中之活血化瘀中药,多为传统草药,少数为近代发现;③从256近代选方,活血化瘀草药组成有一定的配伍,药物归经却较不明显;④活血化瘀虫类药,多属昆虫类,是“血肉有情”、“虫蚁飞走”之品,具有独特的“走窜”生命活性,故破瘀散结之力内服外敷都比草类药强,亦有搜风功能,多用于临床晚期癌症血瘀严重的状况;⑤三棱、莪术是中医抗癌之活血化瘀方剂中最普遍的组合;⑥癌症疼痛是癌症患者常见的晚期症状,情况一为脉络闭阻、瘀塞不通的“不通则痛",常因气滞、血瘀、痰湿、热毒引起;⑦从选方中可观察到中医采用白花蛇舌草在癌症治疗的普遍性;⑧中医在治疗癌症也极少用金属矿物质。
结论:
血瘀是许多疾病极为常见的基本病变和共同病态,对疾病的发展转归有重要影响。肿瘤,从传统中医学理论,是一种全身性疾病的局部表现,是一种病类而非一个病证,其致病因素却非常复杂,两者之间有着复杂、密切的关系。血瘀可以导致恶性肿瘤的发生、发展、转移,对预后有着重要的影响,肿瘤也可引起机体凝血功能的异常,产生血瘀。因此,在抗癌的治疗策略,活血化瘀大法的选用应考虑为各治疗法则中之必然。虽然现在对于活血化瘀是否会导致肿瘤转移还存有争议,但学生认为只要辨证准确,把握好时机,选药恰当,活血化瘀法治疗恶性肿瘤是可以取得很好的疗效的。
Objective
The ecchymosis research is glorious in the traditional traditional Chinese medicine history,the deep pool source and course is long."blood stasis" the concept also therefore has the narrow sense and the generalized difference.The narrow blood stasis(ecchymosis) is refers to the hematocele,to keep the pathology product which the blood,the wicked blood,the extravasated blood,the dried blood,the dead blood,the defeat blood, the blood movement impeded stagnate.The generalized blood stasis has included the narrow ecchymosis, makes a general reference by the phlegm is muddy,the indigestion,plague,the summer heat,cold-damp, factors and so on sentiment will impetusing cause the blood flow to be impeded,either accumulates in the arteries,either overflows outside the arteries,either forms the thrombus,as well as organism nature,the ingredient has the changer.The blood stasis is many disease extremely common basic pathological changes and the common morbid state,sends regarding disease tosses and turns turns over to have the material effect. Has Zhu Bingduo the stasis,sickness long blood stasis,the stasis to live wet muddy,the stasis anti- vitality,the stasis for a long time to enter winds and so on characteristics.
The traditional medicine thought that the tumor is one kind of body-wide disease,but is not the topicality disease,the tumour is the body-wide disease's partial performance.The tumor is one kind of sickness kind,but a non-sickness,its pathogenic factor is very complex.The cause of disease mainly for the external injuries influences attack,the diet injuries,the healthy tendency to owe empty and fine facial expression will being out of balance,the pathogenesis for the stagnation of flow of vital energy blood stasis,the phlegm wet condensation,the painfully hot sun pent up,the internal organs empty damages and so on.The motherland medicine thought that the vitality stasis stagnates is the tumor morbidity basic cause of disease.Vitality being out of balance,the internal combustion engine stagnates strongly fragrant,blood line of impeded,causes the stagnation of flow of vital energy blood stasis,often displays for the blood stasis card.The stasis will tie in the course of time,also will hinder further internal combustion engine's movement,must Cheng xia agglomerate. From the modern oncology angle,the ecchymosis physique's person has the cancer tendency,after the cancer, the malignant transfer rate is obviously high,the recurrence rate is also high,the prognosis is unsatisfactory, the long-enduring blood congeals high the condition and cancer earlier period connection is already established. In addition the tumor occurrence,the development,the shift also with the hemoglutination system exceptionally,the new blood vessel production and so on have the close relation,therefore proposed that in the anticancer treatment treatment strategy,the blood circulation removes extravasted blood big method to select should consider for each treatment principle in the necessity.The modern research indicated that blood circulation removing extravasted blood when the improvement microcycle is unobstructed,also adjusts and the strengthened organism immunologic function,is helpful to tumor suppression,somewhat invigorates the blood to remove extravasted blood Fang Yaogeng to be possible to eliminate the tumour cell directly.
This topic is for the purpose of under the Chinese medicine theory instruction discussing the blood stasis the role which acts particularly to cancer pathological change malignant tumor shift.Will visit the traditional Chinese medicine again in the research process to the blood stasis concept,and will treat cancer and the cancer before modern medicine field of vision thorough discussion blood circulation removing extravasted blood the pathological change effect,as well as its ambiguity and the blood vessel will produce relations.From collects and analyzes each doctor of traditional Chinese medicine in the anticancer treatment effect side medicine and the medicine is right,expected that provides another to control the malignant tumor shift and cancer pathological change's treatment choice.
Method
The student from the ancient times medicine and the modern medicine angle through the consult massive literature,has discussed the blood stasis and the malignant tumor relations,both mutual influence,inseparable, therefore proposed that blood circulation removing extravasted blood may pass through in the treatment malignant tumor throughout,and from the approximately 256 short-term Chinese medicine formula medicinal preparation's analysis,confirmed that the blood circulation removes extravasted blood big method to integrate each kind of cancer to govern in the law,and treats big method and uses with other.Fang Ji who analyzes more or less is had the blood circulation removing extravasted blood Chinese medicine ingredient to blend;Has the ancient medical prescription to add and subtract the blood circulation removing extravasted blood medicine, has the blood circulation removing extravasted blood ancient medical prescription,the ancient Chinese medical classics to cut adds again in view of the condition medicine,also has the simple is the side,has the contemporary Chinese medicine newly organized blood circulation removing extravasted blood side.The analysis has prompted several tendencies or the pattern,in the medicine large dose use,the blood was mad that the medicine will widely utilize,near future Fang Jisou the wind medicine universal utilization,especially at terminal cancer.Through analyzes these side medicinal preparation,may be helpful to the understanding blood circulation removing extravasted blood traditional Chinese medicine characteristic,thus is helpful to the clinical utilization.
Result
The traditional medicine thought that the vitality stasis stagnates is the tumor morbidity basic cause of disease,every cancer lump,must the healthy tendency be weak,masculine and feminine elements being out of balance,the vitality function barrier,causes the stagnation of flow of vital energy blood stasis,to gather the phlegm to congeal wet,in the burning abundant and so on mutually the cemented pathological change.But the blood stasis card forms the basic pathology mechanism may summarize is:The stagnation of flow of vital energy blood stasis,the general rule pain,the blood stasis does not form the ecchymosis agglomeration,sends for the tumour,but Cheng Ailiu.The modern medicine discovered that the malignant tumor,the blood coagulation,the new blood vessel produce three relations to be close.The cancer micro environment is the creation in three kind of different cells,then cancer cell,blood vessel cell and host intersititial cell's mutual information conduction.Long-enduring "the blood congeals the condition to confirm high" to the trouble malignant tumor risk.The cancer cell for in the host in vivo multiplication and the shift,must congeal the system with the blood,the antifreeze system and dissolves the fibrin system to coordinate mutually,its aid, promotes the new blood vessel production,thus before the establishment cancer,the blood congeals the vicious circle.The new blood vessel production is the blood coagulation and the malignant tumor shift center link,the hemoglutination system's essential factor like organization factor,the zymoplasm and non-Shui Rongxing the protein may induces the new blood vessel production through the hemoglutination way and the non-hemoglutination way,thus nourishes the cancer cell the growth.In different tumor each stage obvious ecchymosis sign,thus often displayed "blood circulation removing extravasted blood,to treat different diseases with the same method" the method to pass through the tumor treatment beginning to end.
Blood circulation removing extravasted blood not only may cause the stasis anti- to wind the arteries to pass again,the ache alleviates,may also eliminate the pathology factor which through removing extravasted blood the cancer lump produces,achieves damps the cancer to shrink the lump,the control tumor development goal,thus relieves the pathology physiology mechanism which the cancer pain occurs.The modern research confirmed that the blood circulation traditional Chinese medicine mostly has presses the class and the antifreeze function,but removes extravasted blood the traditional Chinese medicine mostly to have the anti-hitch to dissolve the hitch function.The tumor molecular biology research indicated that the tumor formation and the shift respectively are the cancer gene with damp the cancer gene,the tumor shift gene and the tumor shift suppressor gene combined action result.The experimental study proof blood circulation removing extravasted blood medicine may affect the tumour cell cancer gene the expression and the DNA synthesis,and through suppresses the blood platelet accumulation to prevent the lump cell detention,to reduce the fibrin content,increases the fibrinolysis,suppresses tumour cell's attack to stick two ways to serve the antifreeze purpose.In addition,adjusts the aspect in the immunity,follows also systematically for the human body immunologic function foundation,is the immunity module's carrier,the vitality unsatisfactory immediate influence immunologic function quality,blood circulation removing extravasted blood may promote the human body immunologic function,the prevention cancer.From each sign,when removes extravasted blood the big method treatment malignant tumor before the blood circulation should consider the cancer the blood stasis important and the priority.The anti-new blood vessel production aspect,the modern research discovery, the blood circulation removing extravasted blood medicine has the following several functions,thus serves the purpose which the anti-tumor new blood vessel produces:①The disturbance blood vessel production factor's release or blocks the blood vessel production factor the function;②Suppresses endothelial cell's multiplication;③Is induced tumor necrosis factor(TNF),to enhance the TNF activeness;④Other non-specificity mechanism.
But has the report to execute the blood circulation before clinical to remove extravasted blood big method to treat the cancer and the cancer the pathological change has the ambiguity effect,thus utilizes this big method prevention cancer and the malignant tumor shift compatibility until now was still disputed.The student thinks main and following several spots related:①Lacks the understanding to the symptomless;②The delay governs machine;③The property quality is unclear;④Chooses the medicine prescription to blend the negligence;⑤Envies the medicine and Fang Ji applies drugs the difference to be poor.Above synthesis,so long as has the blood stasis symptom,in principle may select the blood circulation removing extravasted blood medicine,simultaneously can with straighten up the law and use good to;Should when eliminateing the pathogenic factor does not injury positively,straightens up when does not help evilly,with strengthens the patient cellular immunity function the traditional Chinese medicine union use,can obtain a better curative effect.
Includes Chinese medicine of anticancer treatment side medicinal preparation the blood circulation removing extravasted blood ingredient,the origin is many,the student from the innumerable books,the weekly, the magazine obtains near for 20 years 256 to have in blood circulation removing extravasted blood the formula medicinal preparation,by the internal organs classification,in the multianalysis side composes,in the induction process,the observation chooses the medicine the nature,the dosage and presents the frequency in each side medicinal preparation classification,refers to certain traditional Chinese medicine pair work to touch again decides the pair frame,obtains the conclusion.①The newly organized proven prescription many take the ancient medical prescription or the ancient Chinese medical classics as a foundation,adds and subtracts the composition to evolve becomes;②In the proven prescription the blood circulation removing extravasted blood traditional Chinese medicine,many are the traditional herbal medicine,minority for modern discovery;③Chooses the side from 256 modern times,the blood circulation removing extravasted blood herbal medicine composition to have certain blending,the medicine turns over to after not to be actually obvious;④The blood circulation removing extravasted blood insect class medicine,is an insect class,is "the flesh and blood feels emotion","the insects to fly away",has uniquely "walks flees" life activeness,therefore the broken stasis relieves congestion the strength internal medicine to externally apply compared to grass class medicine,also has searches for the wind function,uses in the clinical terminal cancer blood stasis serious condition;⑤The sparganium stoloniferum,e the technique is the Chinese medicine anticancer treatment invigorates the blood to remove extravasted blood in Fang Ji the most universal combination;⑥Cancer ache is cancer patient's common later period symptom,the situation one shuts anti-,the stasis for the vein to fill does not pass "not the general rule pain",because the stagnation of flow of vital energy,the blood stasis,the phlegm are often wet,the painfully hot sun causes;⑦From chooses in the side to be possible to observe the Chinese medicine to use the agkistrodon acutus tongue grass the universality which treats at cancer;⑧The Chinese medicine the treat cancer also little extremely to use the metal mineral substance.
Conclusion
The blood stasis is many disease extremely common basic pathological changes and the common morbid state,sends to disease tosses and turns turns over to have the material effect.The tumor,from the traditional traditional Chinese medicine theory,is one kind of body-wide disease's partial performance,is one kind of sickness kind,but a non-sickness card,its pathogenic factor is actually complex,between both has,the close relationship complex.The blood stasis may cause the malignant tumor the occurrence,the development,the shift,has the important influence to the prognosis,the tumor may also cause organism hemoglutination function unusuality,has the blood stasis.Therefore,in the anticancer treatment treatment strategy,the blood circulation removes extravasted blood big method to select should consider for each treatment principle in the necessity.Although regarding the blood circulation removes extravasted blood now whether to cause thee tumor shift also to have the dispute,but the student thought that so long as dialectical accurate,will grasp the timeliness,will choose the medicine to be appropriate,the blood circulation removing extravasted blood law treatment malignant tumor will be may obtain the very good curative effect.
瘀血的研究在传统中医学历史悠久,源远流长。“血瘀”的概念亦因此有狭义和广义之别。狭义的血瘀(瘀血)是指积血、留血、恶血、蓄血、干血、死血、败血、血液运行不畅而停滞的病理产物。广义的血瘀包括了狭义的瘀血,更泛指由痰浊、食滞、瘟疫、暑热、寒湿、情志刺激等因素导致血液流动不畅,或积于脉内,或溢于脉外,或形成血栓,以及机体性质、成分发生改变者。血瘀是许多疾病极为常见的基本病变和共同病态,对于疾病的发展转归有重要影响。有诸病多瘀、病久血瘀、瘀生湿浊、瘀阻气血、瘀久入络等特点。
传统医学认为肿瘤是一种全身性疾病而不是局部性疾病,肿块是全身性疾病的局部表现。肿瘤是一种病类而非一个病,其致病因素很复杂。病因主要为外邪侵袭、饮食所伤、正气亏虚和精神情志失调,病机为气滞血瘀、痰湿凝聚、热毒蕴结、脏腑虚损等。祖国医学认为气血瘀滞是肿瘤发病的基本病因。气血失调,气机郁滞,血行不畅,导致气滞血瘀,常表现为血瘀证。瘀结日久,又将进一步阻碍气机的运行,必成癥瘕积聚。从现代肿瘤学角度,瘀血体质的人有癌变的倾向,癌变后恶性转移率明显较高,复发率亦较高,预后欠佳,持续性血液高凝状态与癌症前期的关联早已被建立。此外肿瘤的发生、发展、转移还与凝血系统异常、新血管生成等有密切关系,因此提出在抗癌的治疗策略,活血化瘀大法的选用应考虑为各治疗法则中之必然。现代研究表明,活血化瘀在改善微循环通畅之际,亦调整与强化机体免疫功能,有助于对肿瘤的抑制,有些活血化瘀方药更可直接杀灭肿瘤细胞。
本课题旨在中医理论指导下探讨血瘀对癌症病变尤其是恶性肿瘤转移所扮演的角色。在研究过程中会重访传统中医对血瘀的概念,并从现代医学视野深入探讨活血化瘀治疗癌肿及癌前病变效应,以及其双重性与血管生成的关系。从收集和分析各名中医的抗癌效方中的药物和药对,期望提供另一个以控制恶性肿瘤转移和癌症病变的治疗选择。
研究方法:
学生从古代医学及现代医学角度通过查阅大量文献,探讨了血瘀与恶性肿瘤的关系,两者相互影响、密不可分,因此提出活血化瘀可贯穿于治疗恶性肿瘤始终,并从约256个近期中医药方剂的分析,证实活血化瘀大法已融入各种癌症的治法中,并与其他治疗大法并用。被分析的方剂或多或少都有活血化瘀中草药成分配伍;有古方加减活血化瘀药物,有活血化瘀古方、经方化裁再加针对病情的药物,亦有单味药为方,更有当代中医所新编的活血化瘀方。分析提示了几个趋势或模式,药物大剂量的使用、血中气药的广泛运用、近期方剂搜风药的普遍运用,尤在晚期癌症。通过分析这些方剂,可有助于了解活血化瘀中药的特性,从而有助于临床的运用。
研究结果:
传统医学认为气血瘀滞是肿瘤发病的基本病因,凡是癌瘤,必正气虚弱,阴阳失调,气血功能障碍,导致气滞血瘀、湿聚痰凝、火毒内盛等相互胶结的病理变化。而血瘀证形成的基本病理机制可概括为:气滞血瘀,不通则痛,血瘀而形成瘀血积聚,发为肿块而成癌瘤。现代医学发现恶性肿瘤、血液凝固、新血管生成三者关系密切。癌症微环境是创造于三种不同细胞,则癌细胞、血管细胞和宿主间质细胞的相互信息传导。持续性的“血液高凝状态”已证实对患恶性肿瘤的风险。癌细胞为了在宿主体内增殖和转移,必须与血凝系统、抗凝系统和溶纤维蛋白系统相互配合,得其援助,促进新血管生成,从而建立癌前血凝恶性循环。新血管生成是血液凝固和恶性肿瘤转移的中心环节,凝血系统的关键因子如组织因子、凝血酶和非水融性蛋白可通过凝血途径和非凝血途径而诱导新血管生成,从而滋养癌细胞的生长。在不同肿瘤的各个阶段均可见瘀血的征象,因而常施展“活血化瘀、异病同治”之手段贯穿了肿瘤治疗的始末。
活血化瘀不仅可以使瘀阻的络脉再通,疼痛缓解,亦可以通过化瘀消除癌瘤产生的病理因素,达到抑癌缩瘤、控制肿瘤发展的目的,从而解除癌痛发生的病理生理机制。现代研究证实,活血中药大多具有促流和抗凝作用,而化瘀中药大多具有抗栓溶栓作用。肿瘤分子生物学研究表明,肿瘤的形成与转移分别是癌基因与抑癌基因,肿瘤转移基因与肿瘤转移抑制基因共同作用的结果。试验研究证明活血化瘀药可以影响肿瘤细胞癌基因的表达及DNA合成的,并通过抑制血小板聚集防止瘤细胞滞留、降低纤维蛋白含量,增加纤维蛋白溶解,抑制肿瘤细胞的侵袭粘附两个途径达到抗凝目的。此外,在免疫调方面,循还系统为人体免疫功能的基础,是免疫组件的载体,气血欠佳直接影响免疫功能的素质,活血化瘀可提升人体免疫功能,防治癌变。从各种迹象,在运用活血化瘀大法治疗恶性肿瘤时应考虑到癌前血瘀的重要和优先性。抗新血管生成方面,现代研究发现,活血化瘀药有以下几个作用,从而达到抗肿瘤新血管生成的目的:①干扰血管生成因子的释放或阻断血管生成因子的作用;②抑制内皮细胞的增殖;③诱生肿瘤坏死因子(TNF)、提高TNF活性;④其他非特异性机制。
但有报导在临床上施活血化瘀大法治疗癌及癌前病变有双重性的效应,因而至今运用此大法防治癌症及恶性肿瘤转移的适应性仍被争议。学生认为主要与以下几点有关:①对无症状缺乏认识;②延误治机;③药性质量不明;④选药处方配伍疏忽;⑤忌药与方剂用药差劣。综合以上,只要有血瘀症状,原则上就可选用活血化瘀药,同时能与扶正之法并用为佳;则应在祛邪之时不伤正,扶正之余不助邪,与增强患者细胞免疫功能的中药结合使用,才能获得更好的疗效。
含有活血化瘀成份之中医抗癌方剂,来源繁多,学生从无数书籍、周刊、杂志取得近20年来256首有活血化瘀中药方剂,以脏腑分类,详细分析方中组成,在归纳法过程,观察选药的性质、剂量和在每一方剂分类中出现频率,再参考某些中药配对著作以触定配对框架,取得结论。①新编验方多以古方或经方为基础,加减组成演变而成;②验方中之活血化瘀中药,多为传统草药,少数为近代发现;③从256近代选方,活血化瘀草药组成有一定的配伍,药物归经却较不明显;④活血化瘀虫类药,多属昆虫类,是“血肉有情”、“虫蚁飞走”之品,具有独特的“走窜”生命活性,故破瘀散结之力内服外敷都比草类药强,亦有搜风功能,多用于临床晚期癌症血瘀严重的状况;⑤三棱、莪术是中医抗癌之活血化瘀方剂中最普遍的组合;⑥癌症疼痛是癌症患者常见的晚期症状,情况一为脉络闭阻、瘀塞不通的“不通则痛",常因气滞、血瘀、痰湿、热毒引起;⑦从选方中可观察到中医采用白花蛇舌草在癌症治疗的普遍性;⑧中医在治疗癌症也极少用金属矿物质。
结论:
血瘀是许多疾病极为常见的基本病变和共同病态,对疾病的发展转归有重要影响。肿瘤,从传统中医学理论,是一种全身性疾病的局部表现,是一种病类而非一个病证,其致病因素却非常复杂,两者之间有着复杂、密切的关系。血瘀可以导致恶性肿瘤的发生、发展、转移,对预后有着重要的影响,肿瘤也可引起机体凝血功能的异常,产生血瘀。因此,在抗癌的治疗策略,活血化瘀大法的选用应考虑为各治疗法则中之必然。虽然现在对于活血化瘀是否会导致肿瘤转移还存有争议,但学生认为只要辨证准确,把握好时机,选药恰当,活血化瘀法治疗恶性肿瘤是可以取得很好的疗效的。
Objective
The ecchymosis research is glorious in the traditional traditional Chinese medicine history,the deep pool source and course is long."blood stasis" the concept also therefore has the narrow sense and the generalized difference.The narrow blood stasis(ecchymosis) is refers to the hematocele,to keep the pathology product which the blood,the wicked blood,the extravasated blood,the dried blood,the dead blood,the defeat blood, the blood movement impeded stagnate.The generalized blood stasis has included the narrow ecchymosis, makes a general reference by the phlegm is muddy,the indigestion,plague,the summer heat,cold-damp, factors and so on sentiment will impetusing cause the blood flow to be impeded,either accumulates in the arteries,either overflows outside the arteries,either forms the thrombus,as well as organism nature,the ingredient has the changer.The blood stasis is many disease extremely common basic pathological changes and the common morbid state,sends regarding disease tosses and turns turns over to have the material effect. Has Zhu Bingduo the stasis,sickness long blood stasis,the stasis to live wet muddy,the stasis anti- vitality,the stasis for a long time to enter winds and so on characteristics.
The traditional medicine thought that the tumor is one kind of body-wide disease,but is not the topicality disease,the tumour is the body-wide disease's partial performance.The tumor is one kind of sickness kind,but a non-sickness,its pathogenic factor is very complex.The cause of disease mainly for the external injuries influences attack,the diet injuries,the healthy tendency to owe empty and fine facial expression will being out of balance,the pathogenesis for the stagnation of flow of vital energy blood stasis,the phlegm wet condensation,the painfully hot sun pent up,the internal organs empty damages and so on.The motherland medicine thought that the vitality stasis stagnates is the tumor morbidity basic cause of disease.Vitality being out of balance,the internal combustion engine stagnates strongly fragrant,blood line of impeded,causes the stagnation of flow of vital energy blood stasis,often displays for the blood stasis card.The stasis will tie in the course of time,also will hinder further internal combustion engine's movement,must Cheng xia agglomerate. From the modern oncology angle,the ecchymosis physique's person has the cancer tendency,after the cancer, the malignant transfer rate is obviously high,the recurrence rate is also high,the prognosis is unsatisfactory, the long-enduring blood congeals high the condition and cancer earlier period connection is already established. In addition the tumor occurrence,the development,the shift also with the hemoglutination system exceptionally,the new blood vessel production and so on have the close relation,therefore proposed that in the anticancer treatment treatment strategy,the blood circulation removes extravasted blood big method to select should consider for each treatment principle in the necessity.The modern research indicated that blood circulation removing extravasted blood when the improvement microcycle is unobstructed,also adjusts and the strengthened organism immunologic function,is helpful to tumor suppression,somewhat invigorates the blood to remove extravasted blood Fang Yaogeng to be possible to eliminate the tumour cell directly.
This topic is for the purpose of under the Chinese medicine theory instruction discussing the blood stasis the role which acts particularly to cancer pathological change malignant tumor shift.Will visit the traditional Chinese medicine again in the research process to the blood stasis concept,and will treat cancer and the cancer before modern medicine field of vision thorough discussion blood circulation removing extravasted blood the pathological change effect,as well as its ambiguity and the blood vessel will produce relations.From collects and analyzes each doctor of traditional Chinese medicine in the anticancer treatment effect side medicine and the medicine is right,expected that provides another to control the malignant tumor shift and cancer pathological change's treatment choice.
Method
The student from the ancient times medicine and the modern medicine angle through the consult massive literature,has discussed the blood stasis and the malignant tumor relations,both mutual influence,inseparable, therefore proposed that blood circulation removing extravasted blood may pass through in the treatment malignant tumor throughout,and from the approximately 256 short-term Chinese medicine formula medicinal preparation's analysis,confirmed that the blood circulation removes extravasted blood big method to integrate each kind of cancer to govern in the law,and treats big method and uses with other.Fang Ji who analyzes more or less is had the blood circulation removing extravasted blood Chinese medicine ingredient to blend;Has the ancient medical prescription to add and subtract the blood circulation removing extravasted blood medicine, has the blood circulation removing extravasted blood ancient medical prescription,the ancient Chinese medical classics to cut adds again in view of the condition medicine,also has the simple is the side,has the contemporary Chinese medicine newly organized blood circulation removing extravasted blood side.The analysis has prompted several tendencies or the pattern,in the medicine large dose use,the blood was mad that the medicine will widely utilize,near future Fang Jisou the wind medicine universal utilization,especially at terminal cancer.Through analyzes these side medicinal preparation,may be helpful to the understanding blood circulation removing extravasted blood traditional Chinese medicine characteristic,thus is helpful to the clinical utilization.
Result
The traditional medicine thought that the vitality stasis stagnates is the tumor morbidity basic cause of disease,every cancer lump,must the healthy tendency be weak,masculine and feminine elements being out of balance,the vitality function barrier,causes the stagnation of flow of vital energy blood stasis,to gather the phlegm to congeal wet,in the burning abundant and so on mutually the cemented pathological change.But the blood stasis card forms the basic pathology mechanism may summarize is:The stagnation of flow of vital energy blood stasis,the general rule pain,the blood stasis does not form the ecchymosis agglomeration,sends for the tumour,but Cheng Ailiu.The modern medicine discovered that the malignant tumor,the blood coagulation,the new blood vessel produce three relations to be close.The cancer micro environment is the creation in three kind of different cells,then cancer cell,blood vessel cell and host intersititial cell's mutual information conduction.Long-enduring "the blood congeals the condition to confirm high" to the trouble malignant tumor risk.The cancer cell for in the host in vivo multiplication and the shift,must congeal the system with the blood,the antifreeze system and dissolves the fibrin system to coordinate mutually,its aid, promotes the new blood vessel production,thus before the establishment cancer,the blood congeals the vicious circle.The new blood vessel production is the blood coagulation and the malignant tumor shift center link,the hemoglutination system's essential factor like organization factor,the zymoplasm and non-Shui Rongxing the protein may induces the new blood vessel production through the hemoglutination way and the non-hemoglutination way,thus nourishes the cancer cell the growth.In different tumor each stage obvious ecchymosis sign,thus often displayed "blood circulation removing extravasted blood,to treat different diseases with the same method" the method to pass through the tumor treatment beginning to end.
Blood circulation removing extravasted blood not only may cause the stasis anti- to wind the arteries to pass again,the ache alleviates,may also eliminate the pathology factor which through removing extravasted blood the cancer lump produces,achieves damps the cancer to shrink the lump,the control tumor development goal,thus relieves the pathology physiology mechanism which the cancer pain occurs.The modern research confirmed that the blood circulation traditional Chinese medicine mostly has presses the class and the antifreeze function,but removes extravasted blood the traditional Chinese medicine mostly to have the anti-hitch to dissolve the hitch function.The tumor molecular biology research indicated that the tumor formation and the shift respectively are the cancer gene with damp the cancer gene,the tumor shift gene and the tumor shift suppressor gene combined action result.The experimental study proof blood circulation removing extravasted blood medicine may affect the tumour cell cancer gene the expression and the DNA synthesis,and through suppresses the blood platelet accumulation to prevent the lump cell detention,to reduce the fibrin content,increases the fibrinolysis,suppresses tumour cell's attack to stick two ways to serve the antifreeze purpose.In addition,adjusts the aspect in the immunity,follows also systematically for the human body immunologic function foundation,is the immunity module's carrier,the vitality unsatisfactory immediate influence immunologic function quality,blood circulation removing extravasted blood may promote the human body immunologic function,the prevention cancer.From each sign,when removes extravasted blood the big method treatment malignant tumor before the blood circulation should consider the cancer the blood stasis important and the priority.The anti-new blood vessel production aspect,the modern research discovery, the blood circulation removing extravasted blood medicine has the following several functions,thus serves the purpose which the anti-tumor new blood vessel produces:①The disturbance blood vessel production factor's release or blocks the blood vessel production factor the function;②Suppresses endothelial cell's multiplication;③Is induced tumor necrosis factor(TNF),to enhance the TNF activeness;④Other non-specificity mechanism.
But has the report to execute the blood circulation before clinical to remove extravasted blood big method to treat the cancer and the cancer the pathological change has the ambiguity effect,thus utilizes this big method prevention cancer and the malignant tumor shift compatibility until now was still disputed.The student thinks main and following several spots related:①Lacks the understanding to the symptomless;②The delay governs machine;③The property quality is unclear;④Chooses the medicine prescription to blend the negligence;⑤Envies the medicine and Fang Ji applies drugs the difference to be poor.Above synthesis,so long as has the blood stasis symptom,in principle may select the blood circulation removing extravasted blood medicine,simultaneously can with straighten up the law and use good to;Should when eliminateing the pathogenic factor does not injury positively,straightens up when does not help evilly,with strengthens the patient cellular immunity function the traditional Chinese medicine union use,can obtain a better curative effect.
Includes Chinese medicine of anticancer treatment side medicinal preparation the blood circulation removing extravasted blood ingredient,the origin is many,the student from the innumerable books,the weekly, the magazine obtains near for 20 years 256 to have in blood circulation removing extravasted blood the formula medicinal preparation,by the internal organs classification,in the multianalysis side composes,in the induction process,the observation chooses the medicine the nature,the dosage and presents the frequency in each side medicinal preparation classification,refers to certain traditional Chinese medicine pair work to touch again decides the pair frame,obtains the conclusion.①The newly organized proven prescription many take the ancient medical prescription or the ancient Chinese medical classics as a foundation,adds and subtracts the composition to evolve becomes;②In the proven prescription the blood circulation removing extravasted blood traditional Chinese medicine,many are the traditional herbal medicine,minority for modern discovery;③Chooses the side from 256 modern times,the blood circulation removing extravasted blood herbal medicine composition to have certain blending,the medicine turns over to after not to be actually obvious;④The blood circulation removing extravasted blood insect class medicine,is an insect class,is "the flesh and blood feels emotion","the insects to fly away",has uniquely "walks flees" life activeness,therefore the broken stasis relieves congestion the strength internal medicine to externally apply compared to grass class medicine,also has searches for the wind function,uses in the clinical terminal cancer blood stasis serious condition;⑤The sparganium stoloniferum,e the technique is the Chinese medicine anticancer treatment invigorates the blood to remove extravasted blood in Fang Ji the most universal combination;⑥Cancer ache is cancer patient's common later period symptom,the situation one shuts anti-,the stasis for the vein to fill does not pass "not the general rule pain",because the stagnation of flow of vital energy,the blood stasis,the phlegm are often wet,the painfully hot sun causes;⑦From chooses in the side to be possible to observe the Chinese medicine to use the agkistrodon acutus tongue grass the universality which treats at cancer;⑧The Chinese medicine the treat cancer also little extremely to use the metal mineral substance.
Conclusion
The blood stasis is many disease extremely common basic pathological changes and the common morbid state,sends to disease tosses and turns turns over to have the material effect.The tumor,from the traditional traditional Chinese medicine theory,is one kind of body-wide disease's partial performance,is one kind of sickness kind,but a non-sickness card,its pathogenic factor is actually complex,between both has,the close relationship complex.The blood stasis may cause the malignant tumor the occurrence,the development,the shift,has the important influence to the prognosis,the tumor may also cause organism hemoglutination function unusuality,has the blood stasis.Therefore,in the anticancer treatment treatment strategy,the blood circulation removes extravasted blood big method to select should consider for each treatment principle in the necessity.Although regarding the blood circulation removes extravasted blood now whether to cause thee tumor shift also to have the dispute,but the student thought that so long as dialectical accurate,will grasp the timeliness,will choose the medicine to be appropriate,the blood circulation removing extravasted blood law treatment malignant tumor will be may obtain the very good curative effect.
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