北京大学人民医院,北京市西城区西直门南大街11号,100044
fengcuiling@sina.com
收稿:2021-12-11,
修回:2022-03-04,
纸质出版:2022-05-17
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孟玉凤,冯淬灵.基于治未病理论及辨体-辨病-辨证模式的肺结节全程管理初探[J].中医杂志,2022,63(10):927-930.
MENG Yufeng,FENG Cuiling.Preliminary Exploration of the Whole Process Management of Lung Nodules based on the Theory of “Treat Disease before it Arises” and the Constitution-disease-syndrome Differentiation Model[J].Journal of Traditional Chinese Medicine,2022,63(10):927-930.
孟玉凤,冯淬灵.基于治未病理论及辨体-辨病-辨证模式的肺结节全程管理初探[J].中医杂志,2022,63(10):927-930. DOI: 10.13288/j.11-2166/r.2022.10.007.
MENG Yufeng,FENG Cuiling.Preliminary Exploration of the Whole Process Management of Lung Nodules based on the Theory of “Treat Disease before it Arises” and the Constitution-disease-syndrome Differentiation Model[J].Journal of Traditional Chinese Medicine,2022,63(10):927-930. DOI: 10.13288/j.11-2166/r.2022.10.007.
结合中医治未病理论及王琦院士提出的辨体-辨病-辨证模式,针对不同阶段肺结节实施个体化管理。微小结节在辨体质的基础上加用软坚散结、理血祛瘀之品。5 mm以上肺结节根据影像学特征分类管理,良性结节采用辨体论治;符合癌性病变、短期不必手术者,在辨体-辨病基础上结合解毒消瘤法;术后胸痛、咳嗽、气短等并发症常以辨体-辨病-辨证-辨症相结合,以血府逐瘀汤、止嗽散合过敏煎加减,减轻症状;术后需放化疗的患者,以辨证论治为核心兼顾辨体、辨病指导遣方用药,减轻放化疗副作用。全程对患者给予心理疏导,以期达到未病先防、既病防变、瘥后防复的目的。
Individualized management of lung nodules at different stages has been proposed based on the theory of “treat disease before it arise” and the constitution-disease-syndrome differentiation model by Academician WANG Qi. For tiny nodules, the hardness-softening and masses-dissipating, blood-rectifying and stasis-dispelling medicinals are used after differentiating the constitution.Lung nodules larger than 5 mm are treated according to the imaging features, and the management of benign nodules is based on constitution differentiation. For cancerous lesions with no need of surgery in the short term, the method of resolving toxins and dispersing tumors can be used with reference to the constitution-disease differentiation. In terms of postoperative chest pain, cough, shortness of breath and other complications, constitution-disease-syndrome-symptom differentiation should be used, and
Xuefu Zhuyu Decoction
(血府逐瘀汤) and modified
Zhisou Powder
(止嗽散) and
Guomin Decoction
(过敏煎) are recommended to relieve symptoms. For patients in need of radiotherapy and chemotherapy after surgery, syndrome differentiation as the core is used to guide prescriptions, together with constitution differentiation and disease differentiation, so as to reduce the side effects of radiotherapy and chemotherapy. Psychological counseling should be given throughout the whole process, in order to prevent the disease before it arises, control the development of existing disease, and prevent the relapse after the recovery.
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