前列腺偶发癌联合雄激素阻断后辨治四法
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摘要
前列腺偶发癌(IPC)临床常见脾肾两虚、湿热毒蕴、痞热瘀结、气阴两虚等证型,中医药治疗IPC不离扶正祛邪之宗旨,法当调节免疫以扶正、减毒抗癌以祛邪。结合国医名师徐荷芬临床诊疗经验,以"扶正固本、养阴祛瘤"学术思想为纲,"期型分治"为目,探讨IPC不同时期不同证型的辨治方法,概括为温脾补肾、清热燥湿、化痞破瘀、益气养阴等治法;强调带瘤生存,引入生存质量评价,生存质量应包含生活质量和患者满意度,完善IPC疗效评价体系。
In incidental prostate cancer(IPC),the common syndromes are deficiency of spleen and kidney,accumulation of damp-heat toxin,binding of pi and heat,and deficiency of qi and yin. For IPC,the treatment of traditional Chinese medicine(TCM) usually aims at reinforcing healthy qi and dispelling evil qi,and involves regulating immunity to reinforce healthy qi,reducing toxin and fighting against cancer to dispel evil qi. Based on the clinical experience of distinguished TCM master,XU Hefen,with the academic thought of"reinforcing healthy qi and consolidating the root,nourishing yin and removing tumors" as the guideline,and"treatment based on stages" as the classification,the differentiation and treatment methods of different IPC syndromes in different stages were discussed,which are summarized as warming the spleen and tonifying the kidney,clearing away heat and drying dampness,removing pi and breaking stasis,boosting qi and nourishing yin. Survival with tumors has been emphasized,and the evaluation of the survival quality has been introduced,which consists of life quality and patient satisfaction. By doing that,the IPC efficacy evaluation system was improved.
In incidental prostate cancer(IPC),the common syndromes are deficiency of spleen and kidney,accumulation of damp-heat toxin,binding of pi and heat,and deficiency of qi and yin. For IPC,the treatment of traditional Chinese medicine(TCM) usually aims at reinforcing healthy qi and dispelling evil qi,and involves regulating immunity to reinforce healthy qi,reducing toxin and fighting against cancer to dispel evil qi. Based on the clinical experience of distinguished TCM master,XU Hefen,with the academic thought of"reinforcing healthy qi and consolidating the root,nourishing yin and removing tumors" as the guideline,and"treatment based on stages" as the classification,the differentiation and treatment methods of different IPC syndromes in different stages were discussed,which are summarized as warming the spleen and tonifying the kidney,clearing away heat and drying dampness,removing pi and breaking stasis,boosting qi and nourishing yin. Survival with tumors has been emphasized,and the evaluation of the survival quality has been introduced,which consists of life quality and patient satisfaction. By doing that,the IPC efficacy evaluation system was improved.
引文
[1]熊墨年,唐晓玲.中医前列腺癌诊疗指南（草案）[C]//中华中医药学会.2007国际中医药肿瘤大会会刊：2007年卷.北京,2007:4.
[2]温月贤,周迎春,杨叔禹,等.李佩文治疗前列腺癌经验举隅[J].中华中医药杂志,2016,31(8):3109-3111.
[3]刘林涛,刘倩,方志军.徐荷芬治疗肿瘤角药运用举隅[J]江苏中医药,2016,48(12):9-10.
[4]方志军.徐荷芬教授治疗肿瘤学术思想探析[J].辽宁中医药大学学报,2009,11(5):20-22.
[5]MANTENA S K,SHARMA S D,KATIYAR S K.Berberine,a natural product,induces G-phase cell cycle arrest and caspase-3-dependent apoptosis in human prostate carcinoma cells[J].Mol Cancer Ther,2006,5(2):296.
[6]施晓光.异甘草素体外抗肿瘤活性及作用机制研究[D]哈尔滨：东北林业大学,2007.
[7]魏长志,屈岭,寇天芹.抗肿瘤中药集锦[M]．北京：中医古籍出版社,2010:97．
[8]蒋言涛.徐荷芬养阴固本法治疗肿瘤常用对药撷英[J]山东中医药大学学报,2015,39(3):245-246.
[9]张创峰,杨友亮,刘普,等.白花蛇舌草化学成分和药理作用研究进展[J].西北药学杂志,2012,27(4):379.
[10]AHMAD S O,KELLY F,MANECKSHA R P,et al.Survival after incidental prostate cancer diagnosis at transurethral resection of prostate:10-year outcomes.Ir JMed Sci,2012,181(1):27-31．
[11]孙燕,石远凯.临床肿瘤内科手册[M].6版.北京：人民卫生出版社,2015:483.
[12]江琳,李小江,贾英杰,等.益气解毒祛瘀方联合间歇内分泌疗法治疗晚期前列腺癌的临床观察[J].中医药导报,2017,23(15):36-39.
[13]陈东宁,祝宇.去势抵抗性前列腺癌治疗进展[J].现代泌尿外科杂志,2014,19(5):348-352.
[14]宋竖旗,卢建新,张亚强.中医药治疗前列腺癌的新进展与思考[J].中国中西医结合外科杂志,2015,21(6):629-632.
[15]邢海燕,霍介格,方志军.徐荷芬和法论治恶性肿瘤经验[J].中医杂志,2015,56(12):1008-1010.
[2]温月贤,周迎春,杨叔禹,等.李佩文治疗前列腺癌经验举隅[J].中华中医药杂志,2016,31(8):3109-3111.
[3]刘林涛,刘倩,方志军.徐荷芬治疗肿瘤角药运用举隅[J]江苏中医药,2016,48(12):9-10.
[4]方志军.徐荷芬教授治疗肿瘤学术思想探析[J].辽宁中医药大学学报,2009,11(5):20-22.
[5]MANTENA S K,SHARMA S D,KATIYAR S K.Berberine,a natural product,induces G-phase cell cycle arrest and caspase-3-dependent apoptosis in human prostate carcinoma cells[J].Mol Cancer Ther,2006,5(2):296.
[6]施晓光.异甘草素体外抗肿瘤活性及作用机制研究[D]哈尔滨：东北林业大学,2007.
[7]魏长志,屈岭,寇天芹.抗肿瘤中药集锦[M]．北京：中医古籍出版社,2010:97．
[8]蒋言涛.徐荷芬养阴固本法治疗肿瘤常用对药撷英[J]山东中医药大学学报,2015,39(3):245-246.
[9]张创峰,杨友亮,刘普,等.白花蛇舌草化学成分和药理作用研究进展[J].西北药学杂志,2012,27(4):379.
[10]AHMAD S O,KELLY F,MANECKSHA R P,et al.Survival after incidental prostate cancer diagnosis at transurethral resection of prostate:10-year outcomes.Ir JMed Sci,2012,181(1):27-31．
[11]孙燕,石远凯.临床肿瘤内科手册[M].6版.北京：人民卫生出版社,2015:483.
[12]江琳,李小江,贾英杰,等.益气解毒祛瘀方联合间歇内分泌疗法治疗晚期前列腺癌的临床观察[J].中医药导报,2017,23(15):36-39.
[13]陈东宁,祝宇.去势抵抗性前列腺癌治疗进展[J].现代泌尿外科杂志,2014,19(5):348-352.
[14]宋竖旗,卢建新,张亚强.中医药治疗前列腺癌的新进展与思考[J].中国中西医结合外科杂志,2015,21(6):629-632.
[15]邢海燕,霍介格,方志军.徐荷芬和法论治恶性肿瘤经验[J].中医杂志,2015,56(12):1008-1010.