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从两天论看肺癌

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肺癌在中医学中是一种病情复杂、迁延难愈且预后差的疾病.中医学认为,肺癌发生发展中,正虚为本、为源.是什么引起的气血阴阳虚弱?中医古籍中认识不一,笔者通过中医理论、临床工作,结合现代医学,认为正虚主要原因有两点:先天之虚,责之于肾;后天之虚,责之于脾胃.笔者认为肺癌的发生发展及治疗疗效与先天肾及后天脾密切相关.文章从肺癌与先天的关系、肺癌与后天的关系、肺癌与目前抗癌治疗引起的中医证侯变化及在临床中的应用方面综合阐述了肺癌与"两天"的关系.大多数临床医师在治疗中多注重气血痰瘀的证候变化,或采用一成不变的治疗方法,而忽视本虚对疾病的发生发展及预后的影响,特别是抗肿瘤治疗过程中随着疾病治疗及进展而发生的转变.笔者认为放化疗之后多以脾肾虚损为主,机体正气亏虚,影响脏腑阴阳、气血,导致患者病情变化,因此,治疗上不能一成不变的治疗肺癌,而应注重治疗前后患者症状及体质的变化,结合中医证候辨证论治.治疗过程中抓住治疗的根本——正虚,即先天之本肾及后天之本脾胃,肾精充盈,脾气健运,才能有较好的效果.总之,文章通过脾肾生理病理变化对肺癌的影响探讨肺癌的中医病因病机及治疗,以求更好地服务于中医临床工作.
A discussion on lung cancer from the theory of the congenital and the postnatal factors
In traditional Chinese medicine,lung cancer is a kind of disease,with complex changes in the condition,is difficult to cure and has a poor prognosis.Traditional Chinese medicine believes that the occurrence and development of lung cancer are due to healthy Qi(气)deficiency,which is the root cause.What causes deficiency of Qi,blood and Yin(阴)and Yang(阳)?There are different understandings in ancient Chinese medicine books.Based on the theory of traditional Chinese medicine,clinical work,and modem medicine,the author believes that there are two main reasons for the healthy Qi deficiency:congenital deficiency,which is due to the kidney;postnatal deficiency,which is due to the spleen and stomach.The author believes that the occurrence,development and therapeutic effect of lung cancer are closely related to congenital kidney and postnatal spleen.This paper expounds the relationship between lung cancer and the congenital and the postnatal factors from the perspective of the relationship between lung cancer and congenital deficiency,the relationship between lung cancer and postnatal deficiency,the change of TCM syndrome caused by current anti-cancer treatment and its clinical application.Most clinicians pay more attention to the changes of the syndromes of Qi,blood,phlegm and blood stasis in treatment,or use the same treatment methods,while ignoring the impact of deficiency on the occurrence,development and prognosis of the disease,especially the transformation that occurs with the treatment and progression of the disease in the course of anti-tumor treatment.The author believes that after radiotherapy and chemotherapy,spleen-kidney deficiency is the main cause,and the body's healthy Qi deficiency affects the body's Yin and Yang,and Qi and blood,resulting in changes in patients'conditions.Therefore,the treatment of lung cancer can not be static,but should focus on the changes in the patients'symptoms and physical changes before and after treatment,combined with traditional Chinese medicine syndrome differentiation and treatment.In the treatment process,it is needed to grasp the root of the treatment--healthy Qi deficiency,that is,the congenital kidney and the postnatal spleen and stomach,if the kidney essence is full,the spleen Qi will function normally,and better results will be achieved.In short,the paper discusses the etiology,pathogenesis and treatment of lung cancer in traditional Chinese medicine through the impact of physiological and pathological changes in the spleen and kidney on lung cancer,in order to better apply it in clinical work of traditional Chinese medicine.

Lung cancerCongenital kidneyPostnatal spleen and stomachEtiology and pathogenesis of traditional Chinese medicine

张永杰、朱丽平、李爱香、丁婷

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寿光市中医医院,山东 潍坊,262700

肺癌 先天肾 后天脾胃 中医病因病机

2024

中医临床研究
中华中医药学会

中医临床研究

影响因子:0.839
ISSN:1674-7860
年,卷(期):2024.16(24)