1.中国中医科学院广安门医院,北京市西城区北线阁5号,100053
2.北京中医药大学
drjieli2007@126.com
收稿:2023-12-13,
修回:2024-03-20,
纸质出版:2024-06-02
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孙千惠,朱广辉,许博文等.基于气陷理论探析恶性肿瘤术后中医药治疗与康复思路[J].中医杂志,2024,65(11):1120-1125.
SUN Qianhui,ZHU Guanghui,XU Bowen,et al.Postoperative Treatment and Rehabilitation of Malignant Tumor Based on the Theory of Qi Sinking in Traditional Chinese Medicine[J].Journal of Traditional Chinese Medicine,2024,65(11):1120-1125.
孙千惠,朱广辉,许博文等.基于气陷理论探析恶性肿瘤术后中医药治疗与康复思路[J].中医杂志,2024,65(11):1120-1125. DOI: 10.13288/j.11-2166/r.2024.11.006.
SUN Qianhui,ZHU Guanghui,XU Bowen,et al.Postoperative Treatment and Rehabilitation of Malignant Tumor Based on the Theory of Qi Sinking in Traditional Chinese Medicine[J].Journal of Traditional Chinese Medicine,2024,65(11):1120-1125. DOI: 10.13288/j.11-2166/r.2024.11.006.
“气陷”作为中医学理论中的重要概念,是对大气下陷思想内核的承袭和延伸,探析气陷理论中宗气、中气和肾气下陷概念,认为宗气下陷、中气滞陷、肾气虚陷是恶性肿瘤术后损伤核心病机。锚定扶正举陷诸法辨治以掣引升陷,其中肺金戕损,心阳亏虚而宗气下陷,治以升陷汤合桂枝汤加减温补心肺,升举宗气,恢复呼吸功能;脾败枢折,肝失条达而中气滞陷,治以补中益气汤加减温补中气,升阳举陷,促进胃肠康复;源绝精亏,肝失敛藏而肾气虚陷,治以六味地黄丸合升麻柴胡汤加减,旨在滋肾敛肝,固元升提,改善盆底功能障碍。结合不同病势、病期加减配伍,为恶性肿瘤术后中医药治疗与康复提供新思路。
As an important concept in Chinese medicine theory, "
qi
sinking" is the inheritance and extension of the thought core of sinking of
qi
in whole body. This article explored the concept of sinking of pectoral
qi
, center
qi
, and kidney
qi
in the theory of
qi
sinking, and believed that sinking of pectoral
qi
, stagnation and sinking of center
qi
, deficiency and sinking of kidney
qi
were the core pathogenesis of postoperative injury in malignant tumours. Anchored to the method of reinforcing healthy
qi
and lifting the sunken, this article recommended to identify pattern and treat by guiding supplement and lifting the sunken. For lung gold impairment, heart
yang
depletion, and pectoral
qi
sinking, the treatment is to warm and supplement heart and lung, lift pectoral
qi
, and restore the respiratory function by modified
Shengxian Decoction
(升陷汤) plus
Guizhi Decoction
(桂枝汤); for spleen depletion and pathways blockage, liver failing to act freely, and center
qi
stagnation and sinking, the treatment is to warm and supplement center
qi
, raise
yang
and lift the sunken, and restore the digestive function by modified
Buzhong Yiqi Decoction
(补中益气汤); for source exhausted and essence deficiency, liver
qi
hiding, and kidney
qi
deficiency to inward invasion, the treatment is to nourish the kidney and astringe the liver, consolidate the original
qi
and lift
qi
, improve the pelvic floor dysfunction, and protect the kidney function by modified
Liuwei Dihuang Pill
(六味地黄丸) plus
Shengma Chaihu Decoction
(升麻柴胡汤). Modification need base on different disease patterns and stages, and new ideas for postoperative traditional Chinese medicine treatment and rehabilitation of malignant tumours were provided.
HU X , HE W , WEN S , et al . Is IMRT superior or inferior to 3DCRT in radiotherapy for NSCLC? A meta-analysis [J]. PLos One , 2016 , 11 ( 4 ): e0151988 .
AHLBERG K , EKMAN T , GASTON-JOHANSSON F , et al . Assessment and management of cancer-related fatigue in adults [J]. Lancet , 2003 , 362 ( 9384 ): 640 - 650 .
ALLEN MS , DARLING GE , PECHET TT , et al . Morbidity and mortality of major pulmonary resections in patients with early-stage lung cancer: initial results of the rando-mized, prospective ACOSOG Z0030 trial [J]. Ann Thorac Surg , 2006 , 81 ( 3 ): 1013 - 1020 .
BOFFA DJ , ALLEN MS , GRAB JD , et al . Data from the society of thoracic surgeons general thoracic surgery database: the surgical management of primary lung tumors [J]. J Thorac Cardiovasc Surg , 2008 , 135 ( 2 ): 247 - 254 .
RUETH NM , ANDRADE RS . Is VATS lobectomy better:perioperatively, biologically and oncologically? [J]. Ann Thorac Surg , 2010 , 89 ( 6 ): S2107 - S2111 .
RUETH NM , PARSONS HM , HABERMANN EB , et al . The longterm impact of surgical complications after resection of stage Ⅰ nonsmall cell lung cancer: a population-based survival analysis [J]. Ann Surg , 2011 , 254 ( 2 ): 368 - 374 .
CAVALHERI V , JENKINS S , CECINS N , et al . Impairments after curative intent treatment for non-small cell lung cancer: a comparison with age and gender-matched healthy controls [J]. Respir Med , 2015 , 109 ( 10 ): 1332 - 1339 .
李京京 , 吕晓晴 , 刘杉杉 , 等 . 围手术期肺癌患者症状群与生活质量相关性的纵向研究 [J]. 中华护理杂志 , 2020 , 55 ( 11 ): 1635 - 1641 .
董倩 , 林洪生 . 从国外癌症康复现状论中医药在癌症康复中的应用与挑战 [J]. 世界中医药 , 2014 , 9 ( 7 ): 857 - 863 .
程海波 . 癌毒病机理论探讨 [J]. 中医杂志 , 2014 , 55 ( 20 ): 1711 - 1715 .
SU CX , WANG LQ , GRANT SJ , et al . Chinese herbal medicine for cancer-related fatigue: a systematic review of randomized clinical trials [J]. Complement Ther Med , 2014 , 22 ( 3 ): 567 - 579 .
李杰 , 花宝金 , 林洪生 . 从大气下陷理论探讨胸部恶性肿瘤术后症状的辨治 [J]. 中医杂志 , 2014 , 55 ( 21 ): 1822 - 1825 .
曹璐畅 , 李杰 . “升陷培本”法治疗气陷型肿瘤疾病经方与病案举隅 [J]. 辽宁中医杂志 , 2022 , 49 ( 3 ): 32 - 35 .
OKSHOLM T , MIASKOWSKI C , SOLBERG S , et al . Changes in symptom occurrence and severity before and after lung cancer surgery [J]. Cancer Nurs , 2015 , 38 ( 5 ): 351 - 357 .
王高祥 , 章俊强 , 吴明胜 , 等 . 肺部手术后慢性咳嗽诊疗中国专家共识 [J]. 中国胸心血管外科临床杂志 , 2024 , 31 ( 1 ): 1 - 10 .
陈厚赏 , 林凯旋 , 肖国泽 , 等 . 胸腔镜与开胸手术治疗早期非小细胞肺癌的临床疗效分析 [J]. 实用中西医结合临床 , 2018 , 18 ( 7 ): 93 - 94,105 .
徐少华 , 朱金陵 , 周晓 , 等 . 胸腔镜下肺叶切除术与开胸手术治疗早期非小细胞肺癌的疗效比较 [J]. 临床合理用药杂志 , 2018 , 11 ( 23 ): 117 - 118 .
左明焕 , 胡凯文 , 陈信义 . 非小细胞肺癌患者手术前后中医证候特征研究 [J]. 中医杂志 , 2002 , 43 ( 8 ): 615 - 617 .
郝玉凯 . 远端胃癌根治术消化道重建方式与胃瘫的关系 [D]. 长春 : 吉林大学 , 2023 .
郭晨浩 . 袖状胃切除术对肥胖症合并糖尿病的疗效研究 [D]. 太原 : 山西医科大学 , 2021 .
李璐 , 樊志敏 . 直肠癌低位前切除术后排便异常的中医药研究进展 [J]. 上海中医药杂志 , 2013 , 47 ( 2 ): 83 - 85 .
李杰 , 许博文 , 朱广辉 , 等 . 基于五期演变探讨扶正五法在肿瘤防治中的实践与创新 [J]. 北京中医药大学学报 , 2023 , 46 ( 3 ): 321 - 325 .
孙千惠 , 许博文 , 李杰 , 等 . 基于“一气周流、土枢四象”理论探析胃癌的病机与辨治 [J]. 中医杂志 , 2022 , 63 ( 22 ): 2127 - 2129 .
樊宝剑 , 王刚华 , 王金莲 , 等 . 58例宫颈癌患者TP方案化疗前后中医证候变化的临床研究 [J]. 中国现代药物应用 , 2018 , 12 ( 19 ): 198 - 200 .
陈群伟 , 张治国 . 运用奇经理论辨治盆腔及腹腔恶性肿瘤术后虚劳 [J]. 中医杂志 , 2019 , 60 ( 14 ): 1247 - 1248 .
张燕妮 , 李伟娣 , 李金娣 . 盆底肌康复训练联合生物反馈电刺激治疗盆底功能障碍性疾病的临床价值分析 [J]. 实用医技杂志 , 2019 , 26 ( 4 ): 467 - 469 .
李杰 . 五期演变:中医药防治恶性肿瘤理论体系构建及创新 [J]. 北京中医药大学学报 , 2022 , 45 ( 3 ): 223 - 230 .
杜梦梦 , 岳仁宋 . 升陷汤治疗内分泌疾病经验举隅 [J]. 光明中医 , 2017 , 32 ( 21 ): 3168 - 3169 .
吴钱生 , 李蒙丽 , 夏孟蛟 , 等 . 从大气下陷论治肺癌化疗后病证 [J]. 山东中医杂志 , 2019 , 38 ( 3 ): 221 - 224 .
苏春雨 , 朱广辉 , 李杰 . 非小细胞肺癌术后患者症状分布规律及升陷汤加减的干预效果 [J]. 中医杂志 , 2020 , 61 ( 7 ): 601 - 606 .
赵连梅 , 孙佳玮 , 颜晰 , 等 . 中药升陷汤抑制肺癌A549细胞增殖和侵袭转移作用研究 [J]. 中华中医药杂志 , 2011 , 26 ( 9 ): 2147 - 2150 .
万能 , 毛丹 . 补中益气汤加减治疗大肠癌术后腹泻26例临床观察 [J]. 中医药导报 , 2009 , 15 ( 10 ): 33 - 34 .
齐元富 , 孙海燕 , 李慧杰 . 中医药辨证治疗大肠癌术后泄泻举隅 [J]. 实用中医内科杂志 , 2011 , 25 ( 10 ): 44 - 45 .
涂小煌 , 陈志耀 . 补中益气丸联合易蒙停治疗大肠癌术后腹泻疗效观察 [J]. 中国中西医结合杂志 , 2008 , 28 ( 8 ): 738 - 741 .
刘凯 , 王本军 , 马恒 , 等 . 补中益气汤对胃癌术后气虚血瘀证胃肠功能恢复和营养状况的影响 [J]. 中国实验方剂学杂志 , 2015 , 21 ( 24 ): 152 - 156 .
宋晓婕 . 扶正固肾汤对老年卵巢癌术后患者外周血T淋巴细胞亚群及肿瘤标志物的影响 [J]. 中国老年学杂志 , 2020 , 40 ( 10 ): 2078 - 2081 .
赵雅 . 归肾扶正颗粒改善妇科恶性肿瘤手术及化疗后并发症的临床疗效观察 [D]. 泸州 : 西南医科大学 , 2023 .
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