| 徐新宇,崔云,郑军状,等.崔云治疗前列腺癌骨转移临证经验[J].浙江中医药大学学报,2022,46(10):1086-1090, 1097. |
| 崔云治疗前列腺癌骨转移临证经验 |
| CUI Yun‘s Clinical Experience in the Treatment of Bone Metastasis of Prostate Cancer |
| DOI：10.16466/j.issn1005-5509.2022.10.005 |
| 中文关键词: 前列腺癌 骨转移 补益肝肾 扶正祛邪 身心同调 崔云 名医经验 |
| 英文关键词: prostate cancer bone metastasis nourishing the liver and kidney strengthening the body resistance and eliminating evils treatment for mind and body CUI Yun famous doctor‘s experience |
| 基金项目:浙江省自然科学基金项目(LY21H270015)；第六批全国老中医药专家学术经验继承工作项目(国中医药人教发[2017]29号)；浙江省中医药科学研究基金项目(2022ZB337、2022ZB311)；宁波市医疗卫生品牌学科项目(PPXK2018-07) |
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| 中文摘要: |
| [目的] 对崔云教授治疗前列腺癌骨转移的临证经验进行总结。[方法] 通过收集和分析崔教授诊治前列腺癌骨转移患者的临床病例，结合其临证所谈所述，在充分认识病因病机和用药特点的基础上，对崔教授诊治此病的经验进行全面总结，并举典型医案进行论证。[结果] 崔教授对前列腺癌骨转移的病因病机具有深刻认识，他认为肝肾受损、骨气内虚是前列腺癌骨转移的根本，湿热痰瘀胶结癌毒是促进骨转移和诱发骨痛的关键，治疗上重视补益肝肾、扶正壮骨以治本，清除癌毒、祛邪止痛以治标，同时重视放化疗不良反应的调治，包括胃肠道反应、急性放射综合征、骨髓抑制和贫血、肝酶异常，深谙诸症病机，用药精简适宜。此外，崔教授重视本病患者的情绪障碍，主张身心同调，用药之余配以言语疏导，帮助患者树立正确认知、增强战胜疾病的信心，综合手段使得患者生活质量大大提高。所举医案中，患者前列腺癌伴骨转移疼痛，辨为肝肾阴虚、痰瘀互结证，治以补益肝肾、化痰逐瘀，用六味地黄汤合当归贝母苦参丸化裁，坚持扶正祛邪一体观，灵活化裁，效果显著。[结论] 崔教授重视前列腺癌骨转移本虚标实的特点，治疗上坚持扶正祛邪兼顾，合理权衡用药，据证化裁适宜，药物多偏中和而不峻猛，为临证辨治本病提供了很好的借鉴。 |
| 英文摘要: |
| [Objective] To summarize the clinical experience of Professor CUI Yun in the treatment of bone metastasis of prostate cancer. [Methods] Through collecting and analyzing the clinical cases of Professor CUI‘s diagnosis and treatment of patients with bone metastasis of prostate cancer， combining with his clinical discussion， on the basis of fully understanding the etiology， pathogenesis and drug use characteristics， the experience of Professor CUI in diagnosis and treatment of this disease was comprehensively summarized， and a typical medical case was cited for demonstration. [Results] Professor CUI has deep understanding to bone metastasis of prostate cancer‘s etiology and pathogenesis. He thinks the liver and kidney damage and Qi deficiency of bone are the root of bone metastasis of prostate cancer， damp， hot， phlegm and blood stasis sticking with cancer toxin together is the key to promote bone metastasis and bone pain. In treatment， he attaches great importance to tonifying the liver and kidney， tonifying essence and strengthening bone to treat the root; clearing cancer toxin， eliminating evils and relieving pain to relieve the syndrome. At the same time， he pays attention to the treatment of adverse reactions of radiotherapy and chemotherapy， including gastrointestinal reactions， acute radiation syndrome， bone marrow suppression and anemia， abnormal liver enzymes， and has a good understanding of the pathogenesis of above diseases， and the use of simplified drugs is appropriate. In addition， he attaches importance to the emotional disorders of patients with the disease， advocates the integration of body and mind， the use of speech counseling to help patients establish correct cognition， enhances the confidence to overcome the disease， adopts comprehensive means to improve the quality of life of patients greatly. In the medical case mentioned， the patient had prostate cancer accompanied by bone metastasis and pain， which was distinguished as Yin deficiency of the liver and kidney， and phlegm and stasis mutual syndrome. The treatment was to tonify the liver and kidney， remove phlegm and blood stasis. The treatment was made with Liuwei Dihuang Decoction and Danggui Beimu Kushen Pill， adhered to the integral concept of strengthening the body resistance and eliminating evils， modified drug flexibly， and achieved a remarkable effect. [Conclusion] Professor CUI attaches great importance to the characteristics of bone metastasis of prostate cancer， which is deficient root and excessive superficial， and adheres to both strengthening the body resistance and eliminating evils in the treatment， and rationally weighs the use of drugs， modifies drug suitably according to the syndrome， the drugs were mostly moderate but not severe， providing a good reference for the differentiation and treatment of the disease. |
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