| 赵书亚,陈舒怡,舒琦瑾.基于寒热错杂理论探析恶性肿瘤病机及其经方辨治[J].浙江中医药大学学报,2023,47(10):1204-1208. |
| 基于寒热错杂理论探析恶性肿瘤病机及其经方辨治 |
| Discussion on the Pathogenesis and Classical Prescriptions Syndrome Differentiation of Malignant Tumors Based on the Theory of Cold-Heat Complex |
| DOI：10.16466/j.issn1005-5509.2023.10.016 |
| 中文关键词: 恶性肿瘤 病机 阴阳失衡 寒热错杂 辨证论治 《伤寒论》经方 |
| 英文关键词: malignant tumor pathogenesis Yin-Yang imbalance cold-heat complex treatment based on syndrome differentiation classical prescriptions of Treatise on Febrile Diseases |
| 基金项目:浙江省中医药科学研究基金项目(2022ZA075) |
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| 中文摘要: |
| [目的] 基于阴阳失衡、寒热错杂理论，探究恶性肿瘤病机、证治分型及经方治疗。[方法] 通过查阅古籍文献，溯源“寒热错杂”理论，探究恶性肿瘤寒热错杂病因病机的演化过程，并汇通中西，充分认识西医抗肿瘤多元治疗进一步对机体阴阳、寒热平衡的影响，以《伤寒论》为指导，运用八纲及脏腑辨证探讨其经方论治，并以临床验案佐证。[结果] 恶性肿瘤病机冗杂，临床表现多具有矛盾性和寒热错杂的特点，辨治颇为棘手，阴阳失衡是疾病发生发展的本源，从阴阳、寒热失调认识并辨治恶性肿瘤具有重要的临床意义。《伤寒论》开寒热错杂辨证论治之先河，通过参悟仲景思想，认为治疗上可从清肺温脾、清肝温肾、清温中焦、清肠温肾等立法，代表经方包括麻黄升麻汤、乌梅丸、半夏泻心汤、薏苡附子败酱散等。所附肺癌放疗后放射性皮炎验案，其证型归属于脾阳亏虚夹痰热蕴肺之证，治以上清肺热，下温脾寒，方予麻黄升麻汤加减，取得较好的临床疗效。[结论] 阴阳失衡、寒热错杂是恶性肿瘤的关键病机及临床表现，临证中常运用经方治以寒温并用、平调阴阳，患者多有获益。 |
| 英文摘要: |
| [Objective] To discuss the pathogenesis， syndrome classification and the classical prescriptions of malignant tumors based on the theory of Yin-Yang imbalance and cold-heat complex. [Methods] By looking up ancient literature， tracing the theory source of “cold-heat mixed”to explore the etiology and pathogenesis evolution of malignant tumors with cold-heat complex. Moreover， merging Chinese and western medicine， fully understanding the influence of western medicine anti-tumor multiplex therapy on the body， including the balance of Yin-Yang and cold-heat. Under the guide of Treatise on Febrile Diseases， studying on the treatment of classical prescription based on the syndrome differentiation of eight-principle and Zang-Fu viscera， showing an effective clinical case for support. [Results] The pathogenesis of malignant tumors is complicated， and the clinical manifestations are mostly contradictory and cold-heat complex， which represent difficult differentiation and treatment. The imbalance of Yin-Yang is the origin of the occurrence and development of many diseases. Thus， understanding malignant tumors from Yin-Yang and cold-heat has important clinical significance. Treatise on Febrile Diseases created the precedent of syndrome differentiation and treatment of cold-heat complex. By studying Zhongjing’s thought， the treatment can be established from clearing the lung and warming the spleen， clearing the liver and warming the kidney， clearing and warming the middle-Jiao， clearing the intestine and warming the kidney， etc. The representative classical prescriptions include Mahuang Shengma Decoction， Wumei Pill， Banxia Xiexin Decoction， Yiyi Fuzi Baijiang Powder， etc. The attached case of radiation dermatitis after radiotherapy for lung cancer belonged to the syndrome of spleen Yang deficiency with phlegm heat accumulation in the lung. The treatment was to clean lung heat at the upper level and warm spleen cold at the lower level， modified Mahuang Shengma Decoction achieved good clinical efficacy. [Conclusion] Yin-Yang imbalance and cold-heat complex are the key pathogenesis and clinical manifestations of malignant tumors. Patients often benefit from the treatment of classical prescriptions combining cold and heat and adjusting Yin and Yang. |
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