摘要
恶性淋巴瘤是一组原发于淋巴结或其他淋巴造血组织的恶性肿瘤.精准分层、靶向治疗是淋巴瘤新药时代主要治疗模式;耐药复发、并发症、不良反应管理是真实世界的主要挑战;减毒增效是中西整合的优势和目标.癌毒病机学说是周仲瑛国医大师倡导的肿瘤辨治体系;"态靶理论"是仝小林院士提出的现代中医辨治新模式,即"以病为参,以态为基,以症为靶,以因为先,以果为据".通过中医辨证"宏观调态",借助现代医学"微观打靶",最终实现更高层次的中西整合.导师倪海雯教授以癌毒病机理论指导淋巴瘤临床实践,结合态靶理论的核心理念,创新提出"癌毒-态靶"结合的淋巴瘤中西整合临床辨治新模式,紧扣"正虚癌毒"的核心病机,以"消癌解毒方"作为核心靶方,扶正抗癌,贯穿全程;癌毒易损正,把握正邪交争,邪正消长的规律,区分不同阶段;癌毒多夹杂,多因复合,辨析"痰、热、瘀、虚"之夹杂,谨守病机,分别投以化痰、清热、化瘀、益气、养阴以调偏态;针对淋巴瘤常见症状施以对症靶药,结合分子机制进展,针对关键靶点投以相应"标靶"药以精准打靶.构建新药时代"癌毒-态靶"辨治模式,"态靶同调,病证结合",优化中西整合淋巴瘤临床实践.
Abstract
Malignant lymphoma is a group of malignant tumors originating from lymph nodes or other lymphohematopoietic tissues.Delivering an accurate stratification and a targeted treatment is its main treatment mode in the new drug era,while managing drug resistance recurrence,complications,and toxic and side effects is its main challenge in the real world,and reducing toxicity and increasing efficiency is the advantage and goal of the integrated Chinese and western medicine.The cancer toxin pathogenesis theory is a cancer differentiation and treatment system advocated by Zhou Zhongying,a master of traditional Chinese medicine,while the"state-target theory"is a modern differentiation and treatment model of traditional Chinese medicine proposed by Academician Tong Xiaolin,which takes"disease as a reference,states as a basis,symptoms as targets,causes as a priority,and prognosis as evidence".The syndrome differentiation and treatment of traditional Chinese medicine is manipulated to"regulate states in a macrocosmic manner",while modern medicine is applied to"target the microcosmic symptoms",so that a higher level of integration of traditional Chinese and western medicine eventually be achieved.Professor Ni Haiwen,guiding his clinical practice with the cancer toxin pathogenesis theory,combining the core concept of state-target theory,innovatively proposes a new integrated clinical differentiation and treatment mode of lymphoma based on the combination of"cancer toxin-state target".The new mode strictly follows the core pathogenesis of"deficiency of vital qi due to cancer toxin",and uses Xiaoai Jiedu Fang as the core target prescription to strengthen the body resistance and resist cancer toxin throughout the whole process.Given cancer toxin prone to damage vital qi,the new mode is supposed to grasp the law of the conflict between healthy qi and pathogenic factors,and their rise and fall,and to distinguish the changes in different stages.As for the fact that cancer toxin is usually mixed with multiple factors,such as"phlegm,heat,blood stasis,and deficiency",the mode is supposed to observe the pathogenesis closely,and to use drugs respectively to resolve phlegm,clear heat,remove blood stasis,benefit qi,and nourish yin to regulate the abnormal states.In the new mode,targeted drugs are applied to the common symptoms of lymphoma,the progress of molecular mechanism is utilized,and corresponding"targeted"drugs are delivered precisely to key targets.The study is expected to construct a"cancer toxin-state target"mode for lymphoma differentiation and treatment in the new drug era,so as to"regulate states and targets simultaneously,combine the disease with its symptoms",and optimize the clinical practice of lymphoma with integrated Chinese and western medicine.
基金项目
国家中医药管理局第四批全国中医优秀人才研修项目(国中医药办人教函[2017]24号)
江苏省中医药管理局项目(YB2017014)
江苏省卫生健康委重点项目(ZD2021040)
万方数据