肺部多发磨玻璃结节中西医结合防治一体化专家共识  

Expert consensus on the diagnosis and treatment of pulmonary multiple ground-glass nodules by integrated traditional Chinese and western medicine

作　　者：上海市医师协会整合医学分会 史景云 孙奋勇[3] 刘海鹏 陈英群[3] 陈昶 蔚青[3] 申远[3] 孙加源[4] 曹传武[3] 范理宏[3] 李和根[5] Shanghai Medical Association Integrative Medicine Branch

机构地区：[1]不详 [2]同济大学附属上海市肺科医院 [3]同济大学附属第十人民医院 [4]上海市胸科医院 [5]上海中医药大学附属龙华医院

出　　处：《肿瘤》2022年第7期451-465,共15页Tumor

摘　　要：肺部多发磨玻璃结节(ground-glass nodules,GGNs)的发病率在世界范围内呈现明显的上升趋势,目前国内外尚无相关专家共识指导临床实践。当前广泛采用的治疗方法是手术切除主要病灶,但有1/5的患者在术后2年出现第二原发肺癌,并且因肺功能受损的原因导致难以再次手术。近年来,中西医结合医学在此领域的进展迅速,特别是在应用中医药调变能量代谢、改善肺癌内环境和逆转代谢重编程等防治结合方面出现突破,进而实现了在中医药系统治疗下联合应用微无创消融的治疗方式来代替手术切除,达到清除主病灶的同时保护肺功能和防止再发的目的。为此,有必要制订基于临床的中西医结合多学科共识,以发挥中西医结合对该疾病诊治预防一体化的协同优势。上海市医师协会整合医学分会组织胸外科学、呼吸病学、介入肿瘤学、中医学、检验医学、病理学、影像学和心理学等多学科专家制订共识,以期从中西医调控能量代谢的角度更新优化肺部多发GGNs的诊治预防一体化观念。此专家共识提出,采用提升线粒体能量代谢水平的中药治疗联合微无创的物理消融,并且联合饮食、运动、健康生活方式和心理干预等多重干预方法,对肺部多发GGNs患者进行中西医结合管理和规范化治疗,可以达到降低肺癌发病率、延长生存期、保护肺功能、提高生存质量和降低医疗支出的最终目的。The incidence of pulmonary multiple ground-glass nodules(GGNs)is showing a significant upward trend worldwide.At present,there is no relevant expert consensus either domestic or overseas to guide clinical practice.The current widely used treatment is surgical resection of the main lesion,but one in five patients developed a second primary tumor two years later,and it is difficult to perform second operation due to impaired lung function.In recent years,studies in integrated Chinese and western medicine have made rapid progress in this field,especially the latest breakthrough in the use of traditional Chinese medicine to regulate energy metabolism,as well as the combination of prevention and treatment in improving the internal environment of lung cancer and reverting metabolic reprogramming,so that traditional Chinese medicine system treatment combined with minimally non-invasive treatment may serve as an alternative for surgical resection,which can protect lung function and prevent recurrence while removing tumor lesions.Therefore,it is necessary to formulate a clinical multidisciplinary consensus based on integrated traditional Chinese and western medicine,giving full play to the synergistic advantages in traditional Chinese and western medicine,and realizing the integration of diagnosis,treatment and prevention of this disease.To this end,this consensus is jointly formulated by experts in many fields including thoracic surgery,respiratory medicine,interventional oncology,traditional Chinese medicine,laboratory medicine,pathology,radiology and psychology,with a view to updating and optimizing the integrated concept of diagnosis,treatment and prevention of pulmonary multiple GGNs,from the perspective of using traditional Chinese and western medicine to regulate energy metabolism.This consensus proposes to use traditional Chinese medicine therapy to enhance mitochondrial energy metabolism combined with minimally non-invasive physical ablation,as well as multiple intervention methods such as diet,exercise,healthy l

关 键 词：肺部多发磨玻璃结节 GGNs 中西医结合 诊治预防一体化 专家共识 

分 类 号：R734.2[医药卫生—肿瘤]