王祥麒治疗恶性肿瘤骨转移临床用药特点
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摘要
王祥麒教授提出肿瘤骨转移以肾虚为本,肾阴虚是前提,肾阳虚为后发,继而表现为阴阳两虚,肝主筋藏血,肝肾同源,肾精又依赖于肝血的滋养,同时还存在肝血不足的原因。骨失所养,癌邪乘虚而入,留滞骨髓,经络阻塞,聚集成癌。治疗上王教授提出以补肾化痰为主、通络化瘀为辅、止痛贯穿始终。临证用药,常在补肾阴药物的基础上,加入补肾阳药物杜仲,正是效仿阴中求阳之法,常采用熟地黄、杜仲、桑寄生等补肾药物以及化痰散结药物浙贝母、皂角刺、龙骨、牡蛎等。气机不畅是发生瘀血的主要原因,因此将行气化瘀药物蕴于补肾化痰药物之中,如续断、川牛膝、寻骨风、透骨草等。王教授临证还常选用白芍、片姜黄、延胡索等药物,养血柔肝,缓中止痛。
Professor Wang Xiangqi proposed that tumor bone metastasis is Kidney deficiency,with Kidney Yin deficiency is the premise and Kidney Yang deficiency is a posterior condition,which is followed by both Yin and Yang deficiency.Liver governs tendons and blood,and Liver and Kidney are homologue,so Kidney Essence depends on the nourishment of Liver blood.In case of liver blood deficiency,there is a lack of nutrient in bones and then the cancer is taken advantage of that to develop in the bone marrow and to cause the blocked meridians,hence the cancer is integrated.Professor Wang proposes that in treatment tonifying Kidney and dissipating Phlegm should be the main policy,supplementing with dredging collaterals and dispelling stasis to relieve pain.In clinical practice,on the basis of tonifying Kidney Yin drugs,tonifying Kidney Yang drug Eucommia is to applied,which means to follow the method of seeking Yang in the Yin.Besides,drugs like Rehmannia glutinosa,Eucommia,mulberry parasitic and other kidney-reinforcing drugs are often used and drugs Zhejiang Fritillaria,Saponin,Keel,Oysters,etc.to dispel Phlegm and stasis.Abnormal Qi movement is the main cause of blood stasis,so the medicine that can improve Qi movement and dispel stasis are used among the medicine functioning in tonifying Kidney and removing Phlegm,such as Teasel root,Sichuan achyranthes,Berba aristolochiae mollissimae,and Garden balsam Sstem.In Professor Wang′s clinical treatment,drugs such as White peony,Turmeric and Corydalis tuber are also used to nourish the Liver and relieve pain.
Professor Wang Xiangqi proposed that tumor bone metastasis is Kidney deficiency,with Kidney Yin deficiency is the premise and Kidney Yang deficiency is a posterior condition,which is followed by both Yin and Yang deficiency.Liver governs tendons and blood,and Liver and Kidney are homologue,so Kidney Essence depends on the nourishment of Liver blood.In case of liver blood deficiency,there is a lack of nutrient in bones and then the cancer is taken advantage of that to develop in the bone marrow and to cause the blocked meridians,hence the cancer is integrated.Professor Wang proposes that in treatment tonifying Kidney and dissipating Phlegm should be the main policy,supplementing with dredging collaterals and dispelling stasis to relieve pain.In clinical practice,on the basis of tonifying Kidney Yin drugs,tonifying Kidney Yang drug Eucommia is to applied,which means to follow the method of seeking Yang in the Yin.Besides,drugs like Rehmannia glutinosa,Eucommia,mulberry parasitic and other kidney-reinforcing drugs are often used and drugs Zhejiang Fritillaria,Saponin,Keel,Oysters,etc.to dispel Phlegm and stasis.Abnormal Qi movement is the main cause of blood stasis,so the medicine that can improve Qi movement and dispel stasis are used among the medicine functioning in tonifying Kidney and removing Phlegm,such as Teasel root,Sichuan achyranthes,Berba aristolochiae mollissimae,and Garden balsam Sstem.In Professor Wang′s clinical treatment,drugs such as White peony,Turmeric and Corydalis tuber are also used to nourish the Liver and relieve pain.
引文
[1]徐鑫,张孟哲,杜如辛,等.蒋士卿教授运用阳和汤加蜈蚣治疗恶性骨肿瘤经验[J].中医学报,2017,32(1):174-177.
[2]王祥麒,王俊涛,韩倩倩.益肾化痰法治疗恶性肿瘤骨转移35例临床研究[J].中医药信息,2011,28(4):105-107.
[3]侯恩仁.补肾填精壮骨方治疗恶性肿瘤骨转移21例[J].中国民族民间医药,2010,11(2):514.
[4]冯宇,崔艺馨,徐睿鑫.中医药治疗骨转移癌研究进展[J].临床医学,2014,8(1):49-51.
[5]冯利,闫秀峰,何生奇.益肾骨康方对60例肿瘤骨转移癌患者生存质量的影响[J].中医杂志,2014,55(6):49-51.
[6]谢聪,王祥麒.王祥麒教授论治恶性肿瘤骨转移经验[J].中医临床研究,2014,2(3):126-128.
[7]邢润麟,徐波,赵凌睿.基于 thermoTRP 对骨癌痛大鼠模型虚寒型冷痛的机理研究[J].中华中医药学刊,2017,35(7):1735-1740.
[8]许金.热疗联合健骨消痛方治疗骨转移癌疼痛30例临床观察[J].北京中医药,2017,36(8):744-746.
[9]韩尽斌,刘庆,岳小强,等.浅议癌气概念与恶性肿瘤的治疗[J].中医杂志,2012,53(18):1548-1551.
[10]夏孟蛟,由凤鸣,郑川,等.论风药治肿瘤[J].中医杂志,2017,58(2):115-118.
[11]周磊,冯利.益肾骨康方联合热疗辅助西药治疗骨转移癌疼痛患者90例临床研究[J].中医杂志,2015,56(12):1047-1050.
[12]李丽,钱晓萍,刘宝瑞.化疗联合应用帕米膦酸钠治疗肿瘤骨转移的疗效[J].江苏医药,2013,35(1):33-35.
[13]范志松,邢栋,李文毅,等.肿瘤骨转移治疗药物的研究进展[J].中国新药与临床杂志,2016,35(4):234-237.
[14]郑志攀,周仲瑛,叶放,等.国医大师周仲瑛教授辨治癌症正邪关系探析[J].南京中医药大学学报,2016,32(3):201-203.
[15]王菊勇,许玲,张瑞新,等.癌痛的中医药治疗[J].中西医结合学报,2011,9(2):129-134.
[16]陈永安,韩峭青,周敏,等.雷公藤红素对人肝癌 MHCC97H 细胞侵袭转移的影响及机制研究[J].中医学报,2014,24(5):623-625.
[17]张志鹏,刘丽坤,倪育淳.独活寄生汤治疗肿瘤骨转移的临证经验总结[J].光明中医,2017,11(8):157.
[18]王芳,冯利,张平.补肾化瘀中药外敷联合帕米膦酸二钠改善骨转移癌痛[J].中国实验方剂学杂志,2013,17(8):157.
[19]邓博,贾立群,高福云.化瘀止痛方对骨转移癌骨质破坏影响的研究[J].中国实验方剂学杂志,2010,11(16):31-32.
[20]卢海松,王祥麒,姬卫国,等.滋肾化痰方对肿瘤骨转移患者血清BSP指数及生活质量的影响[J].辽宁中医杂志,2017,44(9):1895-1898.
[2]王祥麒,王俊涛,韩倩倩.益肾化痰法治疗恶性肿瘤骨转移35例临床研究[J].中医药信息,2011,28(4):105-107.
[3]侯恩仁.补肾填精壮骨方治疗恶性肿瘤骨转移21例[J].中国民族民间医药,2010,11(2):514.
[4]冯宇,崔艺馨,徐睿鑫.中医药治疗骨转移癌研究进展[J].临床医学,2014,8(1):49-51.
[5]冯利,闫秀峰,何生奇.益肾骨康方对60例肿瘤骨转移癌患者生存质量的影响[J].中医杂志,2014,55(6):49-51.
[6]谢聪,王祥麒.王祥麒教授论治恶性肿瘤骨转移经验[J].中医临床研究,2014,2(3):126-128.
[7]邢润麟,徐波,赵凌睿.基于 thermoTRP 对骨癌痛大鼠模型虚寒型冷痛的机理研究[J].中华中医药学刊,2017,35(7):1735-1740.
[8]许金.热疗联合健骨消痛方治疗骨转移癌疼痛30例临床观察[J].北京中医药,2017,36(8):744-746.
[9]韩尽斌,刘庆,岳小强,等.浅议癌气概念与恶性肿瘤的治疗[J].中医杂志,2012,53(18):1548-1551.
[10]夏孟蛟,由凤鸣,郑川,等.论风药治肿瘤[J].中医杂志,2017,58(2):115-118.
[11]周磊,冯利.益肾骨康方联合热疗辅助西药治疗骨转移癌疼痛患者90例临床研究[J].中医杂志,2015,56(12):1047-1050.
[12]李丽,钱晓萍,刘宝瑞.化疗联合应用帕米膦酸钠治疗肿瘤骨转移的疗效[J].江苏医药,2013,35(1):33-35.
[13]范志松,邢栋,李文毅,等.肿瘤骨转移治疗药物的研究进展[J].中国新药与临床杂志,2016,35(4):234-237.
[14]郑志攀,周仲瑛,叶放,等.国医大师周仲瑛教授辨治癌症正邪关系探析[J].南京中医药大学学报,2016,32(3):201-203.
[15]王菊勇,许玲,张瑞新,等.癌痛的中医药治疗[J].中西医结合学报,2011,9(2):129-134.
[16]陈永安,韩峭青,周敏,等.雷公藤红素对人肝癌 MHCC97H 细胞侵袭转移的影响及机制研究[J].中医学报,2014,24(5):623-625.
[17]张志鹏,刘丽坤,倪育淳.独活寄生汤治疗肿瘤骨转移的临证经验总结[J].光明中医,2017,11(8):157.
[18]王芳,冯利,张平.补肾化瘀中药外敷联合帕米膦酸二钠改善骨转移癌痛[J].中国实验方剂学杂志,2013,17(8):157.
[19]邓博,贾立群,高福云.化瘀止痛方对骨转移癌骨质破坏影响的研究[J].中国实验方剂学杂志,2010,11(16):31-32.
[20]卢海松,王祥麒,姬卫国,等.滋肾化痰方对肿瘤骨转移患者血清BSP指数及生活质量的影响[J].辽宁中医杂志,2017,44(9):1895-1898.