| 沈盛晖.中医膏方在分化型甲状腺癌术后心悸中的应用[J].浙江中医药大学学报,2019,43(7):645-648, 656. |
| 中医膏方在分化型甲状腺癌术后心悸中的应用 |
| The Application of TCM Herbal Paste in Palpitation of Differentiated Thyroid Cancer after Operation |
| DOI：10.16466/j.issn1005-5509.2019.07.004 |
| 中文关键词: 分化型甲状腺癌 术后 心悸 中医膏方 医案 辨证施治 |
| 英文关键词: differentiated thyroid cancer postoperative palpitation TCM herbal paste medical cases treatment based on syndrome differentiation |
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| 中文摘要: |
| [目的]总结笔者运用膏方辨治分化型甲状腺癌术后心悸的临床经验。[方法] 通过对分化型甲状腺癌术后出现心悸的病因病机进行分析，总结笔者运用膏方辨治此类心悸的观点、临床经验及独到之处，并通过案例具体说明。[结果] 笔者认为分化型甲状腺癌术后心悸的病机为术后脏腑失养、阴阳气血亏虚，复因药物扰心、情志内伤。病性虚实兼杂，虚处常见气血不足、阴阳失衡、心神失养，实者为药毒、血瘀、痰饮。临证时应根据心率，辨清虚实病机。制膏时注意选择道地药材，注重辅料。所举验案一属阳气亏虚、痰湿郁滞，拟温阳化浊膏治疗；验案二属气阴两虚、痰瘀互结，治以益气养阴、化痰行瘀，拟养阴通络膏治疗。同时，两案均配以原剂量左甲状腺素钠片，终获良效。[结论]治疗分化型甲状腺癌术后心悸患者，在三因制宜的基础上，注重中西理念融合，参考患者病机、临床用药特点，自拟膏方用于临床，增效防复。膏方药效稳定，患者依从性更高，具有较强的临床推广价值。 |
| 英文摘要: |
| [Objective]To explore the clinical experience of author in treating palpitation of differentiated thyroid cancer after operation with TCM herbal paste. [Methods] Through analyzing the etiology and pathogenesis of palpitation of differentiated thyroid cancer after operation, author's academic thoughts and clinical experience with TCM herbal paste, and specifying typical cases in treatment was summarized. [Results] Zang-fu organs, Qi and blood, Yin and Yang deficiency, compound for drug disturbing, emotional internal injury are the main mechanisms of palpitation of differentiated thyroid cancer after operation. The nature of disease is mixed excessiveness and deficiency, insufficiency of vital energy and blood, imbalance of Yin and Yang, failure of nounrishment of heart and spirit, drug poison, blood stasis, phlegm retention are common. According to the patient’s heart rate, the pathogenesis of deficiency and excess is identified. It is necessary to select genuine medicinal materials for TCM herbal paste prescription, and pay attention to supplementary materials. Case one was differentiated as deficiency of Yang Qi and stagnation of phlegm and dampness, and was treated with Wenyang Huazhuo paste; case two was differentiated as deficiency of Qi and Yin, and phlegm and blood stasis, and was treated with Yangyin Tongluo paste according to therapeutic principles of supplementing Qi and nourishing Yin; eliminating phlegm and removing blood stasis. Both patients achieved good results accompanied with Left Thyroxine Sodium Tablets at original dose. [Conclusion] Author lays emphasis on blending of traditional Chinese and western medicine that combines with three categories of disease cause theory in treating palpitation of differentiated thyroid cancer after operation. In the therapy of self-designed TCM herbal paste, thyroid stimulating hormone inhibition is the basement, pathogenesis and clinical medication characteristics is concerned to keep curative effect. Integrating Chinese and western medicine can increase effect and prevent recurrence. The TCM herbal paste has strong clinical promotion value of popularization for its stable efficacy and good patient's compliance. |
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