| 孙晓静,杨婕,张誉华,等.“培土生金”法在肺癌癌性发热中的应用[J].浙江中医药大学学报,2023,47(2):212-218. |
| “培土生金”法在肺癌癌性发热中的应用 |
| Clinical Experience of “Reinforcing Earth to Generate Metal” in the Treatment of Carcinogenic Fever of Lung Cancer |
| DOI：10.16466/j.issn1005-5509.2023.02.019 |
| 中文关键词: 肺癌 癌性发热 培土生金 肺脾相关 虚则补其母 中医药 理论探讨 验案 |
| 英文关键词: lung cancer carcinogenic fever reinforcing earth to generate metal lung and spleen correlation tonifying the mother organ in case of deficiency traditional Chinese medicine theoretical discussion proved case |
| 基金项目:首都卫生发展科研专项项目(首发2020-2-1023) |
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| 中文摘要: |
| [目的] 探讨“培土生金”法在肺癌癌性发热中的应用，以期为治疗该病提供新思路和新方法。[方法] 基于“肺脾相关”理论，从“培土生金”的释义、脾虚致病的不同机制方面分析肺癌癌性发热的病因病机，探讨“培土生金”法在不同证型的肺癌癌性发热中的选方和用药，并列举临床验案加以佐证。[结果] 肺癌癌性发热的不同证型均与脾虚密切相关，脾胃亏虚，气血两伤，内生虚热；脾失健运，痰瘀互结，滋生湿热；肺脾失和，气机升降失调，内生阴火；内外合邪，阴分伏热。在治疗上应以“培土生金”为基本大法，根据病性虚实和辨证分型化裁出多种补脾之法，给予肺脾同治、补中培元、健脾化湿、调畅气机等药物。验案中患者为晚期肺癌，化疗后出现癌性发热，结合患者症状，综观脉证，考虑病机为肺病及脾、肺脾两虚，故治以补气健脾、培土生金，方选补中益气汤加减以甘温除热，获得较好疗效。[结论] 肺癌癌性发热的病机与“肺脾相关”理论相契合，“培土生金”法对该病的诊疗意义重大，临证应根据不同证型和病性特点辨证施治，值得临床推广应用。 |
| 英文摘要: |
| [Objective] To explore the application of “reinforcing earth to generate metal” method in the treatment of carcinogenic fever of lung cancer， in order to provide new ideas and methods for the treatment of this disease. [Methods] Based on the theory of “lung and spleen correlation”， the etiology and pathogenesis of carcinogenic fever of lung cancer were analyzed from the definition of “reinforcing earth to generate metal” and different pathogenesis of spleen deficiency， and the prescription and medication of this method in different syndrome types of carcinogenic fever of lung cancer were discussed， and clinical case was listed for verification. [Results] Different syndrome types of carcinogenic fever of lung cancer are closely related to spleen deficiency， spleen and stomach deficiency， Qi and blood injury， producing endogenous deficiency heat； spleen loss of health transport， phlegm and blood stasis mutually knot， breeding dampness and heat； lung and spleen disharmony， Qi movement disorder， producing endogenous Yin fire； combination of internal and external evil， causing latent heat in Yin. “Reinforcing earth to generate metal” should be taken as the basic method， according to the nature of disease and syndrome differentiation， cutting out a variety of spleen tonifying methods， giving drugs to benefit both the lung and spleen， replenish the spleen to nourish the vitality， invigorate the spleen and eliminate phlegm， regulate the movement of Qi. The patient in the case was of advanced lung cancer， and developed carcinogenic fever after chemotherapy， combined with the symptoms and the comprehensive view of the pulse syndrome， the pathogenesis was considered as the lung disease affecting the spleen， deficiency of both the lung and spleen， so the treatment should be replenishing Qi and strengthening the spleen， reinforcing earth to generate metal， and Buzhong Yiqi Decoction was modified to remove heat with sweet and warm. [Conclusion] The pathogenesis of carcinogenic fever of lung cancer is consistent with the theory of “lung and spleen correlation”， and “reinforcing earth to generate metal” method is of great significance to the diagnosis and treatment of this disease. It should be treated according to different syndrome types and pathological characteristics， which is worthy of clinical promotion and application. |
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