黄挺教授治疗三苯氧胺所致乳腺癌类围绝经期综合征的经验
|
摘要
目的总结市级名中医黄挺教授治疗乳腺癌三苯氧胺所致类围绝经期综合征的辨证思路。方法通过随师侍诊,归纳整理病例,从三苯氧胺导致类围绝经期综合征的病因病机、主要治法,对黄挺教授治疗乳腺癌三苯氧胺所致类围绝经期综合征的学术观点和临床经验进行探讨分析,并附验案举隅。结果黄挺教授基于临床实践,提出"肝肾阴虚"作为三苯氧胺所致类围绝经期综合征的基本病机,在临床中多以滋补肝肾为大法,治疗此类药物所致的类围绝经期综合征。黄挺教授运用"肝肾阴虚,虚火内扰,冲任失调"的辩证方法治疗4例乳腺癌TAM所致类围绝经期综合征的患者症状改善显著。结论黄挺教授运用"滋补肝肾、交通心肾、调补冲任"的方法辨证论治TAM所致类围绝经期综合征具有独到的临床经验,值得推广和应用。
Objective To summarize the dialectical thinking that tamoxifen causes class perimenopausal syndrome in the treatment of breast cancer from Professor Huang Ting, a municipal famous Chinese medicine doctor. Methods The academic view point and clinical experience of Professor HUANG Ting that the tamoxifen leads to the class peri-menopausal syndrome were explored and analyzed according to the etiology, pathogenesis and the treatment method of tamoxifen leading to class peri-menopausal syndrome, through the division with the teacher and summarizing the case,along with experience and moxibustion. Results Professor HUANG Ting put forward "liver and kidney yin deficiency" as the basic pathogenesis of tamoxifen leading to class perimenopausal syndrome, based on clinical practice. The class perimenopausal syndrome caused by such drugs was mainly treated by the method of nourishing liver and kidney. The symptoms of class perimenopausal syndrome in patients with breast cancer were improved significantly which were treated with the "liver and kidney yinxu, virtual fire disturbance, chong and ren disorders" dialectical method by Professor HUANG Ting. Conclusion Professor HUANG Ting has unique clinical experience in applying "nourishing the liver and kidney, communicating heart and kidney, adjusting the red" method in the treatment of TAM-induced class perimenopausal syndrome, which is worthy of promotion and application.
Objective To summarize the dialectical thinking that tamoxifen causes class perimenopausal syndrome in the treatment of breast cancer from Professor Huang Ting, a municipal famous Chinese medicine doctor. Methods The academic view point and clinical experience of Professor HUANG Ting that the tamoxifen leads to the class peri-menopausal syndrome were explored and analyzed according to the etiology, pathogenesis and the treatment method of tamoxifen leading to class peri-menopausal syndrome, through the division with the teacher and summarizing the case,along with experience and moxibustion. Results Professor HUANG Ting put forward "liver and kidney yin deficiency" as the basic pathogenesis of tamoxifen leading to class perimenopausal syndrome, based on clinical practice. The class perimenopausal syndrome caused by such drugs was mainly treated by the method of nourishing liver and kidney. The symptoms of class perimenopausal syndrome in patients with breast cancer were improved significantly which were treated with the "liver and kidney yinxu, virtual fire disturbance, chong and ren disorders" dialectical method by Professor HUANG Ting. Conclusion Professor HUANG Ting has unique clinical experience in applying "nourishing the liver and kidney, communicating heart and kidney, adjusting the red" method in the treatment of TAM-induced class perimenopausal syndrome, which is worthy of promotion and application.
引文
[1]周纪昌.实用肿瘤内科治疗[M].第2版.北京:北京科学技术出版社,2016:88.
[2]吴子平,陆劲松.乳腺癌内分泌治疗共识与争议[J].临床外科杂志,2016,24(9):663-665.
[3]张培宇.乳腺癌患者使用三苯氧胺的相关副作用及其评价[A].中国中西医结合学会肿瘤专业委员会.第二届国际中西医结合、中医肿瘤学术研讨会论文汇编[C].中国中西医结合学会肿瘤专业委员会,2004:7.
[4]张玉珍.中医妇科学[M].北京:中国中医药出版社,2016:169.
[5]田代华.黄帝内经·素问[M].北京:人民卫生出版社,2005:3-4.
[6]顾书成,管小青,吴骥,等.戈舍瑞林联合三苯氧胺治疗绝经前ER+PR+及ER+PR-复发转移性乳腺癌疗效观察[J].现代肿瘤医学,2011,19(9):1755-1759.
[7]乔华,任建强.耐药晚期乳腺癌临床研究进展[J].国际肿瘤学杂志,2009,36(2):133-135.
[8]朱悦茗,李丹,吴学勇.乳腺癌内分泌治疗研究进展[J].上海医药,2012,(18):9-13.
[9]顾书成,管小青,吴骥,等.戈舍瑞林联合三苯氧胺治疗绝经前ER+PR+及ER+PR-复发转移性乳腺癌疗效观察[J].陕西肿瘤医学,2011,(9):1755-1759.
[10]柴玉林,宋以宁,苏俊强,等.黑升麻根茎提取物治疗乳腺癌患者绝经期症状的研究进展[J].普外基础与临床杂志,2014,(12):1598-1601.
[11]吴丽娜,吴荣.乳腺癌内分泌治疗进展[J].国际肿瘤学杂志,2007,34(5):365-367.
[12]李琳,王淑珍,张震宇,等.乳腺癌患者三苯氧胺治疗后妇科良性疾患的随访研究[J].中华医学杂志,2010,90(25):1735-1738.
[13]赵韬,张汀荣,曹向明,等.Luminal A型乳腺癌个体化治疗初探[J].实用临床医药杂志,2011,15(17):159-164.
[14]王升晔,方美玉,马胜林.芳香化酶抑制剂在乳腺癌新辅助内分泌治疗中的应用[J].国际肿瘤学杂志,2008,35(9):687-690.
[15]侯晓兰.来曲唑与三苯氧胺应用于乳腺癌新辅助内分泌治疗中的比较研究[J].中国现代医生,2012,50(28):48-49.
[16]袁艺,詹云,赵波.消癖散结汤联合三苯氧胺治疗乳腺增生症76例[J].中国医药科学,2012,2(24):94-95.
[17]马小俞,刘哲斌,喻三见,等.三苯氧胺诱导人乳腺癌MCF-7细胞株耐药及自噬的关系研究[J].中国癌症杂志,2011,21(6):421-426.
[18]王巨超,孙成晖,刘红梅,等.调和饮对绝经前乳腺癌PR(+)ER(+)HER-2(-)子宫内膜的影响[J].中医临床研究,2013(18):15-16.
[19]纪新强,孙国臻.三苯氧胺治疗乳腺癌引发卵巢囊肿的临床分析[J].中国综合临床,2003,19(7):660-661.
[20]吴世凯,宋三泰.第三代芳香化酶抑制剂临床应用的常见不良反应[J].中国药物警戒,2006,3(2):68-71.
[21]宋成伟,辛国贤.中西医结合治疗乳腺囊性增生病60例[J].实用中医内科杂志,2011,25(5):99-100
[22]林彩玲.表皮生长因子受体通路在乳腺癌耐药机制中的研究及应用[J].国际肿瘤学杂志,2010,37(11):849-852
[23]李晓龙,王晓翠,魏桃荣,等.中药复方与三苯氧胺片治疗对乳腺癌术后患者CD4、CD8及性激素水平的影响[J].宁夏医学杂志,2013,(12):1195-1197.
[2]吴子平,陆劲松.乳腺癌内分泌治疗共识与争议[J].临床外科杂志,2016,24(9):663-665.
[3]张培宇.乳腺癌患者使用三苯氧胺的相关副作用及其评价[A].中国中西医结合学会肿瘤专业委员会.第二届国际中西医结合、中医肿瘤学术研讨会论文汇编[C].中国中西医结合学会肿瘤专业委员会,2004:7.
[4]张玉珍.中医妇科学[M].北京:中国中医药出版社,2016:169.
[5]田代华.黄帝内经·素问[M].北京:人民卫生出版社,2005:3-4.
[6]顾书成,管小青,吴骥,等.戈舍瑞林联合三苯氧胺治疗绝经前ER+PR+及ER+PR-复发转移性乳腺癌疗效观察[J].现代肿瘤医学,2011,19(9):1755-1759.
[7]乔华,任建强.耐药晚期乳腺癌临床研究进展[J].国际肿瘤学杂志,2009,36(2):133-135.
[8]朱悦茗,李丹,吴学勇.乳腺癌内分泌治疗研究进展[J].上海医药,2012,(18):9-13.
[9]顾书成,管小青,吴骥,等.戈舍瑞林联合三苯氧胺治疗绝经前ER+PR+及ER+PR-复发转移性乳腺癌疗效观察[J].陕西肿瘤医学,2011,(9):1755-1759.
[10]柴玉林,宋以宁,苏俊强,等.黑升麻根茎提取物治疗乳腺癌患者绝经期症状的研究进展[J].普外基础与临床杂志,2014,(12):1598-1601.
[11]吴丽娜,吴荣.乳腺癌内分泌治疗进展[J].国际肿瘤学杂志,2007,34(5):365-367.
[12]李琳,王淑珍,张震宇,等.乳腺癌患者三苯氧胺治疗后妇科良性疾患的随访研究[J].中华医学杂志,2010,90(25):1735-1738.
[13]赵韬,张汀荣,曹向明,等.Luminal A型乳腺癌个体化治疗初探[J].实用临床医药杂志,2011,15(17):159-164.
[14]王升晔,方美玉,马胜林.芳香化酶抑制剂在乳腺癌新辅助内分泌治疗中的应用[J].国际肿瘤学杂志,2008,35(9):687-690.
[15]侯晓兰.来曲唑与三苯氧胺应用于乳腺癌新辅助内分泌治疗中的比较研究[J].中国现代医生,2012,50(28):48-49.
[16]袁艺,詹云,赵波.消癖散结汤联合三苯氧胺治疗乳腺增生症76例[J].中国医药科学,2012,2(24):94-95.
[17]马小俞,刘哲斌,喻三见,等.三苯氧胺诱导人乳腺癌MCF-7细胞株耐药及自噬的关系研究[J].中国癌症杂志,2011,21(6):421-426.
[18]王巨超,孙成晖,刘红梅,等.调和饮对绝经前乳腺癌PR(+)ER(+)HER-2(-)子宫内膜的影响[J].中医临床研究,2013(18):15-16.
[19]纪新强,孙国臻.三苯氧胺治疗乳腺癌引发卵巢囊肿的临床分析[J].中国综合临床,2003,19(7):660-661.
[20]吴世凯,宋三泰.第三代芳香化酶抑制剂临床应用的常见不良反应[J].中国药物警戒,2006,3(2):68-71.
[21]宋成伟,辛国贤.中西医结合治疗乳腺囊性增生病60例[J].实用中医内科杂志,2011,25(5):99-100
[22]林彩玲.表皮生长因子受体通路在乳腺癌耐药机制中的研究及应用[J].国际肿瘤学杂志,2010,37(11):849-852
[23]李晓龙,王晓翠,魏桃荣,等.中药复方与三苯氧胺片治疗对乳腺癌术后患者CD4、CD8及性激素水平的影响[J].宁夏医学杂志,2013,(12):1195-1197.