| 鲁尔旦,倪锴文,王真.王真教授治疗肺癌术后咳嗽的经验[J].浙江中医药大学学报,2020,44(4):367-369. |
| 王真教授治疗肺癌术后咳嗽的经验 |
| Professor WANG Zhen's Experience in Treating Cough after Lung Cancer Operation |
| DOI：10.16466/j.issn1005-5509.2020.04.012 |
| 中文关键词: 肺癌术后 咳嗽 王真 辨证论治 医案 名医经验 |
| 英文关键词: postoperative lung cancer cough WANG Zhen syndrome differentiation and treatment medical case experience of famous doctors |
| 基金项目:2012年度国家自然科学基金资助项目(81273679) |
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| 中文摘要: |
| [目的]总结王真教授治疗肺癌术后咳嗽的经验。[方法]跟随王真教授临诊，收集肺癌术后咳嗽的病案，并查阅肺癌术后咳嗽的相关文献，结合当前西医学对于肺癌术后咳嗽机制的研究，总结王真教授关于肺癌术后咳嗽中医病因病机的认识，以及临床常见的证型和对应的治疗方药，并举验案一则加以佐证。[结果]现代医学认为，肺癌术后咳嗽可能与纵隔淋巴结清扫、肺C纤维受损、解剖结构改变、胃食管反流、瞬时受体电位香草酸亚型1(transient receptor potential vanilloid 1,TRPV1)表达增加、气管插管等有关。王真教授认为肺癌术后咳嗽患者总的病机特点属本虚标实，本为气血不足、肺阴亏虚，标为风邪、痰邪、气逆、气滞等。常见证型有风咳型、胃气上逆型、痰热郁肺型、咽喉不利型、肝郁气滞型等，临床上常自拟经验方或化裁经典验方如旋覆代赭汤、半夏厚朴汤、柴胡疏肝散等，并常于药方中酌加补益气血、滋阴润肺之品，止咳不忘补虚。所举验案属胃气上逆型咳嗽，治以旋覆代赭汤加减，和胃降逆，清肺化痰止咳，取得较好疗效。[结论]王真教授在治疗肺癌术后咳嗽上注重病证统筹，分型施治，临床疗效显著，值得传承推广。 |
| 英文摘要: |
| [Objective]To summarize Professor WANG Zhen's experience in treating cough after postoperative lung cancer. Collect the cases of postoperative cough of lung cancer in Professor WANG Zhen's outpatient clinic, and review the relevant literature on postoperative cough in lung cancer. Combine the current research on the mechanism of postoperative cough in lung cancer, and summarize Professor WANG Zhen's understanding of the TCM pathogenesis of postoperative cough in lung cancer, as well as the common clinical syndrome types and the corresponding prescriptions. A typical medical case is attached to explain it. [Results]Modern medicine believes that cough after lung cancer may be related to mediastinal lymph node dissection, lung C fiber damage, anatomical changes, gastroesophageal reflux, increased expression of TRPV1(transient receptor potential vanilloid 1), endotracheal intubation and so on. Professor WANG Zhen believes that the overall pathogenesis of patients with cough after lung cancer surgery is deficiency in origin and enrichment in symptom, which is the deficiency of Qi and blood, the deficiency of lung Yin, and the symptoms are wind evil, phlegm evil, Qi reverse, Qi stagnation and so on. The common syndrome types include wind cough type, stomach Qi inversion type, phlegm heat stagnation lung type, throat discomfort type, liver Qi stagnation type, and so on. In clinical practice, he often develops his own prescriptions or formulates classical prescriptions such as Xuanfu Daizhe Decoction, Banxia Houpu Decoction, Chaihu Shugan Powder, etc. And often add medicines to replenish Qi and blood, nourish Yin and nourish lungs in the prescription. Do not forget to remedy deficiency while relieving cough. The test case was of stomach Qi reverse cough, which was treated with “Xuanfu Daizhe Decoction”, harmonizing stomach and lowering adverse Qi, clearing the lungs, removing phlegm and relieving cough, and achieved good curative effect. [Conclusion]In the treatment of postoperative cough of lung cancer, Professor WANG Zhen pays attention to the overall planning of disease and syndrome, syndrome differentiation and treatment. And clinical results are significant, it is worth promoting. |
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