从气血理论简析大肠癌的中医药治疗
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摘要
基于气血理论分析,大肠癌是以气血失和为发病基础,以气滞、血瘀、水湿为重要病理因素的虚实夹杂的慢性疾病。大肠癌治疗需攻补兼施,气血失和以补虚为主,气滞、血瘀、水湿则以祛邪为主,具体针对气血虚型、气滞型、血瘀型、水湿型患者应分别治以补益气血、行气通滞、逐瘀散结、祛湿化瘀,可分别选用八珍汤、四逆散和厚朴三物汤、大黄牡丹汤和温经汤、薏苡附子败酱散加减治疗。临证结合扶正祛邪理论、辨病与辨证相结合及癌毒致癌的特异性,配伍相应抗肿瘤中药以增强抗癌功效,可提高大肠癌中医药治疗的临床疗效。
According to qi-blood theory,colorectal cancer is a chronic disease with intermingled deficiency and excess,based on the disharmony of qi and blood and with qi stagnation,blood stasis,and water dampness as important pathological factors. The treatment needs both reinforcement and elimination. Therefore,for patients with disharmony of qi and blood,the treatment should be tonifying deficiency,and for patients with qi stagnation,blood stasis,and water dampness,they should be treated with eliminating pathogen. Specifically,patients with deficiency of qi and blood,stagnation of qi,blood stasis,and water dampness should be treated with tonifying qi and blood,promoting qi circulation to remove stagnation,dispersing stasis and resolving masses and eliminating dampness and absorbing clots.The representative prescriptions were Bazhen Decoction( 八珍汤),Sini Powder( 四逆散) and Houpo Sanwu Decoction( 厚朴三物汤),Dahuang Mudan Decoction( 大黄牡丹汤) and Wenjing Decoction( 温经汤),and modified Yiyi Fuzi Baijiang Powder( 薏苡附子败酱散). Combined with the theory of strengthening healthy qi and eliminating pathogens,the combination of disease differentiation and syndrome differentiation,and the specificity of carcinogenesis caused by cancer toxin,the compatibility of anti-tumor Chinese medicine was used to enhance the anti-cancer effect,and improve the clinical curative effect of TCM treatment of colorectal cancer.
According to qi-blood theory,colorectal cancer is a chronic disease with intermingled deficiency and excess,based on the disharmony of qi and blood and with qi stagnation,blood stasis,and water dampness as important pathological factors. The treatment needs both reinforcement and elimination. Therefore,for patients with disharmony of qi and blood,the treatment should be tonifying deficiency,and for patients with qi stagnation,blood stasis,and water dampness,they should be treated with eliminating pathogen. Specifically,patients with deficiency of qi and blood,stagnation of qi,blood stasis,and water dampness should be treated with tonifying qi and blood,promoting qi circulation to remove stagnation,dispersing stasis and resolving masses and eliminating dampness and absorbing clots.The representative prescriptions were Bazhen Decoction( 八珍汤),Sini Powder( 四逆散) and Houpo Sanwu Decoction( 厚朴三物汤),Dahuang Mudan Decoction( 大黄牡丹汤) and Wenjing Decoction( 温经汤),and modified Yiyi Fuzi Baijiang Powder( 薏苡附子败酱散). Combined with the theory of strengthening healthy qi and eliminating pathogens,the combination of disease differentiation and syndrome differentiation,and the specificity of carcinogenesis caused by cancer toxin,the compatibility of anti-tumor Chinese medicine was used to enhance the anti-cancer effect,and improve the clinical curative effect of TCM treatment of colorectal cancer.
引文
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[18]崔文燕,刘素香,宋晓凯,等.黄花败酱草和白花败酱草的化学成分与药理作用研究进展[J].药物评价研究,2016,39(3):482-488.
[19]李琦玮,于明薇,王笑民.癌毒理论研究现状[J].中医杂志,2015,56(4):347-350.
[20]张朝玉,应小平.《神农本草经》抗肿瘤中药统计分析[J].国医论坛,2016,31(5):58-60.
[2]韩晓伟,马贤德,关洪全.中医“气血津液”学说与现代免疫学思想[J].中华中医药学刊,2009,27(7):1380-1381.
[3]吕金朋,张乔,张辉,等.人参化学成分及药理作用研究[J].吉林中医药,2017,37(12):1261-1263.
[4]邵晶,郭玫.黄芪化学成分及药理作用研究进展[J].中医临床研究,2015,7(25):22-25.
[5]于泓苓.中药当归的化学成分分析与药理作用研究[J].中西医结合心血管病杂志,2018,6(21):90-92.
[6]杜怡波,樊慧蓉,阎昭.阿胶的化学成分及药理作用研究进展[J].天津医科大学学报,2018,24(3):267-270.
[7]孙笕.血瘀证辨证与大肠癌转移相关性的临床研究[D].杭州:浙江中医药大学,2014:12.
[8]杨志超,陈海雁,徐伟帆.结肠癌患者凝血纤溶系统改变及其临床意义探讨[J].中国现代药物应用,2018,12(7):46-48.
[9]纪云飞,王瑞君,李晓波.复方四君子汤的化学成分和药理作用研究进展[J].中草药,2016,47(5):837-843.
[10]曾柳庭,刘慧萍,杨凯麟,等.四物汤有效成分的关联性分析[J].中成药,2017,39(3):576-582.
[11]张霄潇,李正勇,马玉玲,等.中药枳实的研究进展[J].中国中药杂志,2015,40(2):185-190.
[12]郭珊珊,王谦,白立川,等.芍药-甘草配伍的研究进展[J].中草药,2014,45(10):1481-1485.
[13]戴克敏.姜春华教授运用芍药甘草汤的经验[J].陕西中医,1990,11(5):193-194.
[14]王晓亮,郑伟.消化系统恶性肿瘤患者血液流变学指标检测的临床价值[J].实用癌症杂志,2016,31(12):1951-1953.
[15]张保国,刘庆芳.大黄牡丹汤现代药效学研究与临床应用[J].中国药学杂志,2009,44(21):1601-1604.
[16]以敏,徐君毅,郝二伟,等.桃仁提取物抗血瘀证大鼠血栓形成的机制[J].中国实验方剂学杂志,2016,22(1):125-128.
[17]赵婕,王明力,汤翠,等.薏苡仁功能活性成分的研究进展[J].食品工业科技,2016,37(18):374-377.
[18]崔文燕,刘素香,宋晓凯,等.黄花败酱草和白花败酱草的化学成分与药理作用研究进展[J].药物评价研究,2016,39(3):482-488.
[19]李琦玮,于明薇,王笑民.癌毒理论研究现状[J].中医杂志,2015,56(4):347-350.
[20]张朝玉,应小平.《神农本草经》抗肿瘤中药统计分析[J].国医论坛,2016,31(5):58-60.