蒋士卿治疗膀胱癌经验
|
摘要
蒋士卿教授主张中西医结合治疗膀胱癌,西医采用外科手术和膀胱内灌注化疗等;中医采用辨证与辨病相结合。膀胱癌术后、膀胱灌注后应用加味猪苓汤为主方,补益肾气,清热利湿,化瘀解毒,以防复发,辨证属心火旺者与黄连阿胶汤合方;辨证属肝火旺者在加味猪苓汤基础上加柴胡、黄芩、牡丹皮、栀子或合方丹栀逍遥散;病久大虚患者用十全大补汤加减。在治疗膀胱癌术后患者时,蒋士卿教授不主张补脾而以茯苓、砂仁运脾。对于膀胱癌术后复发的患者,蒋士卿教授则注重脾肾同调,采用健脾补肾之法。膀胱癌术后复发患者预后较差,主张中医药尽早介入治疗。
Professor Jiang Shiqing advocates the treatment of bladder cancer with the combination of traditional Chinese and Western medicine. Western medicine adopts surgery and intravesical instillation of chemotherapy. TCM uses the combination of syndrome differentiation and disease differentiation. After bladder cancer operation and bladder perfusion,Supplemented Polyporus Decoction is used as the main prescription to nourish kidney qi,clear away heat and dampness,remove blood stasis and detoxify,so as to prevent recurrence. For those with excessive heart fire,Coptis and Colla Corii Asini Decoctionis combined. For excessive liver fire,Chaihu(Radix Bupleuri),Huangqin(Radix Scutellariae),Mudanpi(Cortex Moutan) and Zhizi(Fructus Gardeniae)can be added or Xiaoyao Powder of Cortex Moutan and Fructus Gardeniae is combined. For excessive deficiency due to chronic disease,Modified Ten Major Tonics Decoction can be combined. In the treatment of patients with bladder cancer after operation,Professor Jiang Shiqing does not advocate invigorating the spleen but activating the spleen by Fuling(Poria) and Zhusha(Cinnabaris). For patients with recurrence of bladder cancer after operation,Professor Jiang Shiqing pays attention to regulating the spleen and kidney together and adopts the method of invigorating the spleen and invigorating the kidney. The prognosis of patients with recurrence of bladder cancer after operation is poor,so it is advocated that traditional Chinese medicine should be intervened as soon as possible.
Professor Jiang Shiqing advocates the treatment of bladder cancer with the combination of traditional Chinese and Western medicine. Western medicine adopts surgery and intravesical instillation of chemotherapy. TCM uses the combination of syndrome differentiation and disease differentiation. After bladder cancer operation and bladder perfusion,Supplemented Polyporus Decoction is used as the main prescription to nourish kidney qi,clear away heat and dampness,remove blood stasis and detoxify,so as to prevent recurrence. For those with excessive heart fire,Coptis and Colla Corii Asini Decoctionis combined. For excessive liver fire,Chaihu(Radix Bupleuri),Huangqin(Radix Scutellariae),Mudanpi(Cortex Moutan) and Zhizi(Fructus Gardeniae)can be added or Xiaoyao Powder of Cortex Moutan and Fructus Gardeniae is combined. For excessive deficiency due to chronic disease,Modified Ten Major Tonics Decoction can be combined. In the treatment of patients with bladder cancer after operation,Professor Jiang Shiqing does not advocate invigorating the spleen but activating the spleen by Fuling(Poria) and Zhusha(Cinnabaris). For patients with recurrence of bladder cancer after operation,Professor Jiang Shiqing pays attention to regulating the spleen and kidney together and adopts the method of invigorating the spleen and invigorating the kidney. The prognosis of patients with recurrence of bladder cancer after operation is poor,so it is advocated that traditional Chinese medicine should be intervened as soon as possible.
引文
[1]矫宾宾,张萌,李荣强,等.非肌层浸润性膀胱癌手术治疗现状[J].现代泌尿生殖肿瘤杂志,2018,10(5):317-320.
[2]那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊治指南[M].北京:人民卫生出版社,2013:55.
[3]PANG C,GUAN Y,LI H,et al.Urologic cancer in China[J].Jpn J Clin Oncol,2016,46(6):497-501.
[4]LYNCH C F,COHEN M B.Urinary system[J].Cancer,1995,75(1):316-328.
[5]刘军.年龄和性别对膀胱癌的临床病理特征的影响[D].青岛:青岛大学,2012.
[6]钟赣生.中药学[M].北京:中国中医药出版社,2012:356-357.
[7]崔红海,蒋士卿.蒋士卿教授运用虫类药物治疗恶性肿瘤经验[J].中医学报,2015,30(5):621-623.
[8]HALL MC,CHANG SS,DALBAGNI G,et al.Guideline for the management of non muscle invasive bladder cancer(stages Ta,T1,and Tis):2007 update[J].J Urol,2007,178(6):2314-2330.
[9]秦英刚,花宝金,陈宏,等.花宝金教授治疗膀胱癌经验探析[J].吉林中医药,2012,32(11):1095-1097.
[10]王辉,孙桂芝.孙桂芝治疗膀胱癌经验[J].北京中医药,2011,30(7):492-493.
[11]李结实,金星,彭成华,等.常德贵教授运用中医药治疗膀胱癌经验[J].中医学报,2012,27(2):172-173.
[2]那彦群,叶章群,孙颖浩,等.中国泌尿外科疾病诊治指南[M].北京:人民卫生出版社,2013:55.
[3]PANG C,GUAN Y,LI H,et al.Urologic cancer in China[J].Jpn J Clin Oncol,2016,46(6):497-501.
[4]LYNCH C F,COHEN M B.Urinary system[J].Cancer,1995,75(1):316-328.
[5]刘军.年龄和性别对膀胱癌的临床病理特征的影响[D].青岛:青岛大学,2012.
[6]钟赣生.中药学[M].北京:中国中医药出版社,2012:356-357.
[7]崔红海,蒋士卿.蒋士卿教授运用虫类药物治疗恶性肿瘤经验[J].中医学报,2015,30(5):621-623.
[8]HALL MC,CHANG SS,DALBAGNI G,et al.Guideline for the management of non muscle invasive bladder cancer(stages Ta,T1,and Tis):2007 update[J].J Urol,2007,178(6):2314-2330.
[9]秦英刚,花宝金,陈宏,等.花宝金教授治疗膀胱癌经验探析[J].吉林中医药,2012,32(11):1095-1097.
[10]王辉,孙桂芝.孙桂芝治疗膀胱癌经验[J].北京中医药,2011,30(7):492-493.
[11]李结实,金星,彭成华,等.常德贵教授运用中医药治疗膀胱癌经验[J].中医学报,2012,27(2):172-173.