张冰治癌三法
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摘要
张冰教授根据肿瘤病因病机变化提出中医治癌三法,即扶正固本法、祛邪法、护肝肾法。扶正固本法用药特点:如属气阴两虚,治以益气养阴;如属阳气不足,治以补肾温阳填精;如属气血虚弱,治以健脾益气,养血和血。祛邪法用药特点:如属痰浊阻滞,治以化痰降浊;如属瘀血停滞,治以祛瘀活血;如属肝脾气结,治以理气散结;另外,张冰教授重视结合现代药理研究,临床筛选白花蛇舌草,重楼,半边莲,败酱草,鱼腥草等清热解毒类中药。本法临床应用当慎重,且不可长期大剂量应用。护肝肾法用药特点:在放疗、化疗阶段,使用中药保肝益肾,常用药物有:白芍、五味子、甘草等;通过控制处方药味数量及剂量减少肝肾损伤,视患者耐受情况逐渐增加,同时每个处方的用药时间为一至两周,避免连续、长期用药;对于有小毒类中药严格掌握有毒药物的剂量及用药时长;定期检查肝肾功能;多选性平、凉为主,慎用温燥助阳之品以防温燥伤津耗气,损伤正气。
Professor Zhang Bing puts forward three methods of treating cancer in TCM according to the changes of the etiology and pathogenesis of cancer,namely,strengthening genuine qi and restoring normal functioning of the body to consolidate the constitution,eliminating pathogenic factors,protecting liver and kidney. The medication characteristics of strengthening genuine qi and restoring normal functioning of the body to consolidate the constitution are as follows: For qi-yin deficiency,supplementing qi and nourishing yin can be used. For yang deficiency,nourishing the kidney and warming yang and replenishing essence can be used.For qi-blood deficiency,invigorating spleen and nourishing qi,tonifying blood and harmonizing blood can be used. The medication characteristics of eliminating pathogenic factors are as follows: For phlegm turbidity blockade,resolving phlegm and reducing turbidity can be used. For stagnation of blood stasis,removing blood stasis and activating blood circulation can be used. For liverspleen qi stagnation,regulating qi and dispersing blood stasis can be used. In addition,Professor Zhang Bing attaches great importance to the combination of modern pharmacological research,clinically screens Baihuasheshecao( Herba Hedyotis Diffusae),Chonglou( Rhizoma Paridis),Banbianlian( Herba Lobeliae Chinensis),Baijiangcao( Herba Patriniae) and Yuxingcao( Herba Houttuyniae),etc. to clear heat and remove toxic substance. The clinical application of this method should be cautious,and it should not be used for a long time in large doses. The medication characteristics of protecting liver and kidney are as follows: In the stage of radiotherapy and chemotherapy,Chinese herbal medicine is used to protect liver and kidney. The commonly used drugs include Baishao( Radix Paeoniae Alba),Wuweizi( Fructus Schisandrae Chinensis),Gancao( Radix et Rhizoma Glycyrrhizae),etc. The quantity of medicinal ingredients and dosage of a prescription is controlled to reduce liver and kidney injury,and they will gradually increase according to the patient's tolerance. At the same time,the medication time of each prescription will be one to two weeks. Try to avoid continuous and long-term medication. Try to control the dosage and duration of toxic drugs for small toxic traditional Chinese medicines strictly. Check liver and kidney function regularly. Choose medicinals with neutral and cool nature,and cautiously use the ones with functions of warming and dry nature to nourish yang in order to prevent from hurting fluid and consuming qi,damaging healthy qi.
Professor Zhang Bing puts forward three methods of treating cancer in TCM according to the changes of the etiology and pathogenesis of cancer,namely,strengthening genuine qi and restoring normal functioning of the body to consolidate the constitution,eliminating pathogenic factors,protecting liver and kidney. The medication characteristics of strengthening genuine qi and restoring normal functioning of the body to consolidate the constitution are as follows: For qi-yin deficiency,supplementing qi and nourishing yin can be used. For yang deficiency,nourishing the kidney and warming yang and replenishing essence can be used.For qi-blood deficiency,invigorating spleen and nourishing qi,tonifying blood and harmonizing blood can be used. The medication characteristics of eliminating pathogenic factors are as follows: For phlegm turbidity blockade,resolving phlegm and reducing turbidity can be used. For stagnation of blood stasis,removing blood stasis and activating blood circulation can be used. For liverspleen qi stagnation,regulating qi and dispersing blood stasis can be used. In addition,Professor Zhang Bing attaches great importance to the combination of modern pharmacological research,clinically screens Baihuasheshecao( Herba Hedyotis Diffusae),Chonglou( Rhizoma Paridis),Banbianlian( Herba Lobeliae Chinensis),Baijiangcao( Herba Patriniae) and Yuxingcao( Herba Houttuyniae),etc. to clear heat and remove toxic substance. The clinical application of this method should be cautious,and it should not be used for a long time in large doses. The medication characteristics of protecting liver and kidney are as follows: In the stage of radiotherapy and chemotherapy,Chinese herbal medicine is used to protect liver and kidney. The commonly used drugs include Baishao( Radix Paeoniae Alba),Wuweizi( Fructus Schisandrae Chinensis),Gancao( Radix et Rhizoma Glycyrrhizae),etc. The quantity of medicinal ingredients and dosage of a prescription is controlled to reduce liver and kidney injury,and they will gradually increase according to the patient's tolerance. At the same time,the medication time of each prescription will be one to two weeks. Try to avoid continuous and long-term medication. Try to control the dosage and duration of toxic drugs for small toxic traditional Chinese medicines strictly. Check liver and kidney function regularly. Choose medicinals with neutral and cool nature,and cautiously use the ones with functions of warming and dry nature to nourish yang in order to prevent from hurting fluid and consuming qi,damaging healthy qi.
引文
[1]叶燕妮,杨忠光.中医对肿瘤放疗后毒性反应的辨析与施治[J].贵州医药,2012,36(1):71-72.
[2]张英,侯炜,林洪生.中医药治疗恶性肿瘤临床研究成果与思考[J].中医杂志,2014,55(6):523-525.
[3]廖思,李惠林,赵恒侠.国医大师张学文治疗恶性肿瘤经验撷要[J].江苏中医药,2019,51(1):20-22.
[4]阎力君,洪涛,王福玲,等.黄芪多糖水提工艺的优化及其体外抗肿瘤活性[J].中成药,2017,39(10):2045-2049.
[5]张冰.临床中药学[M].北京:中国中医药出版社,2012:146.
[6]林举择,梁荣华,黄旭晖.王昌俊教授治疗化疗相关性骨髓抑制的经验[J].环球中医药,2018,11(8):1310-1312.
[7]张冰.临床中药学理论与实践[M].北京:人民卫生出版社,2018:208.
[8]周伟龙,张冰.孟河京派治疗眩晕的临床用药经验传承研究[J].天津中医药大学学报,2018,37(3):206-209.
[9]张冰.常用中药合理用药实践[M].北京:人民卫生出版社,2017:18.
[10]张景岳.景岳全书[M].李玉清,主校.北京:中国医药科技出版社,2011:156-158.
[11]杨舟,江劲波.健脾益肾生髓方治疗急性淋巴细胞白血病化疗后白细胞减少症的疗效及对患者血清超氧化物歧化酶、脂质过氧化物的影响[J].河北中医,2018,40(3):348-352.
[12]芮冉,焦佩娟,张朝玉,等.提高机体抗肿瘤免疫中药的现代研究[J].吉林中医药,2018,38(3):325-327,338.
[13]周斌,张毅.慢性炎症微环境与肿瘤[J].临床检验杂志,2017,35(11):840-843.
[14]汤芷妮,骆云鹏,葛菲,等.活血化瘀抗肿瘤中草药作用机制的研究进展[J].中国药房,2016,27(8):1146-1149.
[15]周仲瑛,吴勉华.中医辨治肿瘤十法[J].南京中医药大学学报,2018,34(6):541-548.
[16]李卫东,花宝金.中医药防治肿瘤的不同治法概述[J].医学综述,2012,18(2):269-272.
[17]杨淑慧,佘世锋,曹敏,等.劳绍贤分型辨治慢性萎缩性胃炎经验[J].广州中医药大学学报,2019,36(1):124-127.
[18]黄越燕,周吉芳,徐佳颖.有毒中药抗肿瘤作用的研究进展[J].山东医药,2017,57(2):108-112.
[19]张玉杰,李明春,张华,等.半边莲药理作用及机制的研究进展[J].中国药师,2015,18(8):1376-1378.
[20]王永恒,张冰.张冰教授“治秘四法”经验[J].河北中医,2018,40(10):1449-1451,1462.
[21]张冰.中药安全与合理应用导论[M].北京:中国中医药出版社,2017.
[22]董一珠,褚梦真.《本草纲目》中有毒中药的药物警戒思想:草部[J].医药导报,2019,38(1):37-41.
[23]刘雪丽,周学锋,王君瑜,等.中药抗肿瘤作用机制研究进展[J].中国药师,2016,19(6):1158-1162.
[2]张英,侯炜,林洪生.中医药治疗恶性肿瘤临床研究成果与思考[J].中医杂志,2014,55(6):523-525.
[3]廖思,李惠林,赵恒侠.国医大师张学文治疗恶性肿瘤经验撷要[J].江苏中医药,2019,51(1):20-22.
[4]阎力君,洪涛,王福玲,等.黄芪多糖水提工艺的优化及其体外抗肿瘤活性[J].中成药,2017,39(10):2045-2049.
[5]张冰.临床中药学[M].北京:中国中医药出版社,2012:146.
[6]林举择,梁荣华,黄旭晖.王昌俊教授治疗化疗相关性骨髓抑制的经验[J].环球中医药,2018,11(8):1310-1312.
[7]张冰.临床中药学理论与实践[M].北京:人民卫生出版社,2018:208.
[8]周伟龙,张冰.孟河京派治疗眩晕的临床用药经验传承研究[J].天津中医药大学学报,2018,37(3):206-209.
[9]张冰.常用中药合理用药实践[M].北京:人民卫生出版社,2017:18.
[10]张景岳.景岳全书[M].李玉清,主校.北京:中国医药科技出版社,2011:156-158.
[11]杨舟,江劲波.健脾益肾生髓方治疗急性淋巴细胞白血病化疗后白细胞减少症的疗效及对患者血清超氧化物歧化酶、脂质过氧化物的影响[J].河北中医,2018,40(3):348-352.
[12]芮冉,焦佩娟,张朝玉,等.提高机体抗肿瘤免疫中药的现代研究[J].吉林中医药,2018,38(3):325-327,338.
[13]周斌,张毅.慢性炎症微环境与肿瘤[J].临床检验杂志,2017,35(11):840-843.
[14]汤芷妮,骆云鹏,葛菲,等.活血化瘀抗肿瘤中草药作用机制的研究进展[J].中国药房,2016,27(8):1146-1149.
[15]周仲瑛,吴勉华.中医辨治肿瘤十法[J].南京中医药大学学报,2018,34(6):541-548.
[16]李卫东,花宝金.中医药防治肿瘤的不同治法概述[J].医学综述,2012,18(2):269-272.
[17]杨淑慧,佘世锋,曹敏,等.劳绍贤分型辨治慢性萎缩性胃炎经验[J].广州中医药大学学报,2019,36(1):124-127.
[18]黄越燕,周吉芳,徐佳颖.有毒中药抗肿瘤作用的研究进展[J].山东医药,2017,57(2):108-112.
[19]张玉杰,李明春,张华,等.半边莲药理作用及机制的研究进展[J].中国药师,2015,18(8):1376-1378.
[20]王永恒,张冰.张冰教授“治秘四法”经验[J].河北中医,2018,40(10):1449-1451,1462.
[21]张冰.中药安全与合理应用导论[M].北京:中国中医药出版社,2017.
[22]董一珠,褚梦真.《本草纲目》中有毒中药的药物警戒思想:草部[J].医药导报,2019,38(1):37-41.
[23]刘雪丽,周学锋,王君瑜,等.中药抗肿瘤作用机制研究进展[J].中国药师,2016,19(6):1158-1162.
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