李戈辨治恶性肿瘤出血  

LI Ge’s Differentiation and Treatment of Malignant Tumor Hemorrhage

作　　者：李璐玮 李戈[2] 赵岩[2] LI Luwei;LI Ge;ZHAO Yan(Grade 2016 Grade Students of Internal Medicine of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,China;Oncology Department of Dalian Traditional Chinese Medicine Hospital,Dalian 116013,China)

机构地区：[1]辽宁中医药大学研究生学院,沈阳110032 [2]大连市中医医院肿瘤科,大连116013

出　　处：《实用中医内科杂志》2019年第5期1-3,共3页Journal of Practical Traditional Chinese Internal Medicine

摘　　要：生活方式改变及老龄化的加重,导致恶性肿瘤发病率出现上升趋势,但随着现代医学的快速发展,经积极治疗,患者生存期可明显延长,恶性肿瘤并发症成为影响生存期的主要问题,甚至影响治疗的依从性。出血为恶性肿瘤常见并发症,虽有出血位置不同,但根据临床表现,均可属祖国医学"血证"范畴,是血液不循脉道,或上溢于口鼻官窍、或下泄于前后二阴,或渗出于皮肤。李戈教授认为感受外邪、情志不畅、饮食不节、劳欲体虚及久病未愈等均是导致血证的主要原因,而肿瘤血证多与"热邪""气病""瘀毒内结"有关,导致火热熏灼、迫血妄行,气不摄血、血溢脉外,且病机之间常相互转化,经久不愈。针对肿瘤出血特点,李戈教授提出"辨病位病因、辨虚实、辨出血量"的独到见解,先明确病变脏腑及致病因素,再明辨虚实,治疗时抓住正虚邪实的主要矛盾,根据患者兼证,酌情予以对症治疗,善用具有抗癌效果的中药药对,并不忘兼顾抗肿瘤药物的不良反应,以增效减毒思想贯穿治疗始终,治疗过程中切不可忽略出血量,大量出血者应进行输血治疗,快速救治,对提高肿瘤患者生存期生活质量具有重要意义。The change of life style and the aggravation of aging lead to the rising incidence of malignant tumors.However, with the rapid development of modern medicine, the survival time of patients can be significantly prolonged after active treatment. The complications of malignant tumors have become the main problem affecting survival time, and even affect the compliance of treatment. Hemorrhage is a common complication of malignant tumors. Although the location of hemorrhage is not needed, it belongs to the category of "blood syndrome" of traditional Chinese medicine according to its clinical manifestations. It is a disease caused by blood not following the vein, or overflowing into the orifices of the mouth, nose or nose, or discharging into the anterior and posterior Yins, or seeping out of the skin. Professor LI Ge believes that the main causes of blood syndrome are feeling exogenous pathogens, emotional disorders, improper diet, exhaustion and physical deficiency, and long-term illness. Tumor blood syndrome is mostly related to "heat pathogen","Qi disease" and "blood stasis and toxin internal knot". It leads to fire and heat fumigation, blood rush, Qi does not ingest blood, blood spills out, and the pathogenesis often transforms each other and does not heal for a long time. In view of the characteristics of tumor hemorrhage, Professor Li Ge put forward his unique opinion of "distinguishing the cause of disease, deficiency and excess, and the amount of bleeding". Firstly, the viscera and pathogenic factors of the disease were identified clearly, then the deficiency and excess were identified clearly. During the treatment, the main contradiction between deficiency and excess was grasped. According to the patient’s concurrent syndrome, symptomatic treatment was given as appropriate, and the Chinese medicine pairs with anti-cancer effect were used well,and the adverse reactions of anti In the course of treatment, the amount of bleeding should not be neglected.The patients with massive bleeding should be treated with

关 键 词：恶性肿瘤 出血 血证 肺癌 输尿管癌 名老中医经验 李戈 

分 类 号：R249[医药卫生—中医临床基础] R273[医药卫生—中医学]