基于卫气营血-脏腑辨证体系论治放射性肺损伤
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摘要
放疗是治疗胸部恶性肿瘤的一个重要手段,但往往会对正常肺组织造成损伤。运用中医药理论预防和治疗放射性肺损伤具有一定的优势。从中医学角度,放射性肺损伤的证候、病机是一个由浅入深的动态演变过程,其临床表现具有温病卫气营血的传变特点,但卫气营血辨证存在定位不明确和后期分期不完整等不足之处,故提出卫气营血-脏腑辨证体系,构建卫气营血分期与脏腑定位相结合的辨证论治方案,为临床辨证论治放射性肺损伤提供思路。
Radiotherapy plays an important role in the treatment of thoracic malignancies,but at the same time causes varying degrees of damage to normal lung tissue surrounding the tumor.In recent years,traditional Chinese medicine highlights certain advantages in the prevention and treatment of radiation-induced lung injury.Radiationinduced lung injury is a dynamic process and has certain correlation with the transmutation rule of Weiqi Yingxue.However,there is a problem that the positioning is not clear and the late stage is not complete.Therefore,it is proposed that Syndrome differentiation system from Weiqi Yingxue and Zangfu should be used for the clinical diagnosis and treatment of RILI.
Radiotherapy plays an important role in the treatment of thoracic malignancies,but at the same time causes varying degrees of damage to normal lung tissue surrounding the tumor.In recent years,traditional Chinese medicine highlights certain advantages in the prevention and treatment of radiation-induced lung injury.Radiationinduced lung injury is a dynamic process and has certain correlation with the transmutation rule of Weiqi Yingxue.However,there is a problem that the positioning is not clear and the late stage is not complete.Therefore,it is proposed that Syndrome differentiation system from Weiqi Yingxue and Zangfu should be used for the clinical diagnosis and treatment of RILI.
引文
[1]Palma DA,Senan S,Tsujino K,et al.Predicting Radiation Pneumonitis after Chemoradiotherapy for Lung Cancer:An International Individual Patient Data Meta-analysis[J].Int J Radiat Oncol Biol Phys,2013,85(20):444-450.
[2]Vogelius IR,Bentzen SM.A literature-based meta-analysisof clinical risk factors for development of radiation in-duced pneumonitis[J].Acta Oncol,2012,51(8):975-983.
[3]Giridhar P,Mallick S,Rath GK,et al.Radiation Induced Lung Injury:Prediction,Assessment and Management[J].Asian Pac J Cancer Prev,2015,16(7):2613-2617.
[4]刘利胜,刘美芹.当归补血合剂对放射性肺炎小鼠血清转化生长因子和超氧化物歧化酶的影响[J].中国卫生检验杂志,2016,26(20):2920-2924.
[5]傅饶,孔令苓.清燥救肺汤预防和治疗放射性肺炎的临床观察[J].中国医药指南,2011,9(11):29-30.
[6]李霞,王公道.益气活血中药治疗放射性肺损伤的疗效分析[J].中医临床研究,2016,8(3):96-97.
[7]由凤鸣,郑川,祝捷,等.从“火郁发之”论治放射性肺损伤[J].中医杂志,2015,56(21):1819-1821.
[8]蔡红兵,罗荣城.放射性肺损伤的中医药防治方法探讨[J].第一军医大学学报,2003,23(9):958-960.
[9]窦永起,杨明会,林明雄,等.放射性肺损伤中医证候学特点及其演变规律的研究[J].中华中医药杂志,2009,24(6):706-708.
[10]燕忠生.放射性肺炎中医病机、治法及用药规律分析[J].现代中西医结合杂志,2013,229(36):4053-4055.
[11]蔡红兵,罗荣城.放射性肺损伤的中医药防治方法探讨[J].第一军医大学学报,2003,23(9):958-960.
[12]齐宝芳,朝阳.对“卫气营血辨证”的体会[J].中国实用医药,2011,6(23):231.
[13]秦建.卫气营血辨证理论的临床应用研究[D].南京.南京中医药大学,2009.
[14]刘树林.基于六经与卫气营血辨证体系贯通的经典方证整理与运用研究[D].广州:广州中医药大学,2013.
[15]郭海,杨进.对卫气营血理论的思考[J].中医药信息,2007,24(1):3-5.
[16]刘亚敏.卫气营血辨证临床运用的构思[J].实用中医内科杂志,2006,20(3):221-222.
[17]皮立宏,吴敏.卫气营血辨证理论的临床应用研究[J].光明中医,2016,31(6):758-760.
[18]李超,古立丽.养阴清热化瘀汤联合胸部肿瘤放疗对急性放射性肺炎的临床疗效[J].中国实验方剂学杂志,2016,22(22):165-169.
[19]郑洪亮,徐艳玲.浅谈放射性肺炎的辨治体会[J].辽宁中医药大学学报,2009,11(6):62-63.
[20]田梅,张伟.论肺为血脏[J].中华中医药杂志,2014,29(3):680-681.
[21]Lefran觭ais E,Ortiz-Mu觡oz G,Caudrillier A,et al.The lung is a site of platelet biogenesis and a reservoir for haematopoietic progenitors[J].Nature advance online publication,2017.
[22]周晓娜.骆学新教授分期论治放射性肺损伤经验[J].甘肃中医药大学学报,2016,33(2):22-25.
[23]刘志艳,林洪生.林洪生中医药防治放疗毒副反应经验[J].北京中医药,2016,35(7):664-667.
[24]王珏,张卫平.加味麻杏石甘汤防治放射性肺损伤的临床研究[J].天津中医药,2011,28(5):377-378.
[25]贾新华,陈宪海,张兴彩,等.肺纤维化从“痹”论治[J].中医药信息,2013,30(20):1-3.
[26]Martinez FJ,Keane MP.Update in diffuse parenchymal lung diseases 2005[J].Am J Respir Crit Care Med,2006,173(10):1066-1071.
[2]Vogelius IR,Bentzen SM.A literature-based meta-analysisof clinical risk factors for development of radiation in-duced pneumonitis[J].Acta Oncol,2012,51(8):975-983.
[3]Giridhar P,Mallick S,Rath GK,et al.Radiation Induced Lung Injury:Prediction,Assessment and Management[J].Asian Pac J Cancer Prev,2015,16(7):2613-2617.
[4]刘利胜,刘美芹.当归补血合剂对放射性肺炎小鼠血清转化生长因子和超氧化物歧化酶的影响[J].中国卫生检验杂志,2016,26(20):2920-2924.
[5]傅饶,孔令苓.清燥救肺汤预防和治疗放射性肺炎的临床观察[J].中国医药指南,2011,9(11):29-30.
[6]李霞,王公道.益气活血中药治疗放射性肺损伤的疗效分析[J].中医临床研究,2016,8(3):96-97.
[7]由凤鸣,郑川,祝捷,等.从“火郁发之”论治放射性肺损伤[J].中医杂志,2015,56(21):1819-1821.
[8]蔡红兵,罗荣城.放射性肺损伤的中医药防治方法探讨[J].第一军医大学学报,2003,23(9):958-960.
[9]窦永起,杨明会,林明雄,等.放射性肺损伤中医证候学特点及其演变规律的研究[J].中华中医药杂志,2009,24(6):706-708.
[10]燕忠生.放射性肺炎中医病机、治法及用药规律分析[J].现代中西医结合杂志,2013,229(36):4053-4055.
[11]蔡红兵,罗荣城.放射性肺损伤的中医药防治方法探讨[J].第一军医大学学报,2003,23(9):958-960.
[12]齐宝芳,朝阳.对“卫气营血辨证”的体会[J].中国实用医药,2011,6(23):231.
[13]秦建.卫气营血辨证理论的临床应用研究[D].南京.南京中医药大学,2009.
[14]刘树林.基于六经与卫气营血辨证体系贯通的经典方证整理与运用研究[D].广州:广州中医药大学,2013.
[15]郭海,杨进.对卫气营血理论的思考[J].中医药信息,2007,24(1):3-5.
[16]刘亚敏.卫气营血辨证临床运用的构思[J].实用中医内科杂志,2006,20(3):221-222.
[17]皮立宏,吴敏.卫气营血辨证理论的临床应用研究[J].光明中医,2016,31(6):758-760.
[18]李超,古立丽.养阴清热化瘀汤联合胸部肿瘤放疗对急性放射性肺炎的临床疗效[J].中国实验方剂学杂志,2016,22(22):165-169.
[19]郑洪亮,徐艳玲.浅谈放射性肺炎的辨治体会[J].辽宁中医药大学学报,2009,11(6):62-63.
[20]田梅,张伟.论肺为血脏[J].中华中医药杂志,2014,29(3):680-681.
[21]Lefran觭ais E,Ortiz-Mu觡oz G,Caudrillier A,et al.The lung is a site of platelet biogenesis and a reservoir for haematopoietic progenitors[J].Nature advance online publication,2017.
[22]周晓娜.骆学新教授分期论治放射性肺损伤经验[J].甘肃中医药大学学报,2016,33(2):22-25.
[23]刘志艳,林洪生.林洪生中医药防治放疗毒副反应经验[J].北京中医药,2016,35(7):664-667.
[24]王珏,张卫平.加味麻杏石甘汤防治放射性肺损伤的临床研究[J].天津中医药,2011,28(5):377-378.
[25]贾新华,陈宪海,张兴彩,等.肺纤维化从“痹”论治[J].中医药信息,2013,30(20):1-3.
[26]Martinez FJ,Keane MP.Update in diffuse parenchymal lung diseases 2005[J].Am J Respir Crit Care Med,2006,173(10):1066-1071.