高瞻治疗前列腺癌雄激素剥夺治疗后代谢并发症的临床经验  

Gao Zhan’s Clinical Experience in the Treatment of Androgen Deprivation of Metabolic Complications in Prostate Cancer

作　　者：陈豪特 高瞻[1] 张泽家 王忠[1,2] 谢佳琪 蔡斌斌 杨小琴 Chen Haote;Gao Zhan;Zhang Zejia;Wang Zhong;Xie Jiaqi;Cai Binbin;Yang Xiaoqin(Xiyuan Hospital of China Academy of Chinese Medical Sciences,Beijing 100091,China;Graduate School of the China Academy of Chinese Medical Sciences,Beijing 100027,China;Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China;The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530000,China)

机构地区：[1]中国中医科学院西苑医院,北京100091 [2]中国中医科学院研究生院,北京100027 [3]北京中医药大学研究生院,北京100029 [4]广西中医药大学第一附属医院,南宁530000

出　　处：《世界科学技术-中医药现代化》2021年第12期4537-4542,共6页Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology

基　　金：北京市健康卫生委员会首都卫生发展科研专项项目(首发2020-2-2033):芪芍天心方剂治疗前列腺癌根治术后早期尿失禁的多中心随机对照临床研究,负责人:王建文;中国中医科学院名医名家传承项目(CM20141002):张广生学术思想与临床经验传承研究,负责人:高瞻。

摘　　要：“雄激素剥夺治疗后代谢并发症”是转移性前列腺癌行雄激素剥夺治疗临床常见并发症,在控制肿瘤的同时影响生活质量和总生存率。高瞻教授基于《金匮要略》思想发挥从“虚劳”论治“雄激素剥夺治疗后代谢并发症”并提出:该病的病因为医药致病;主要病机是“脾肾两虚”,随病程发展形成痰瘀为主的病理;在治疗上确立“健脾益肾”的治法;自拟“健脾益肾方”根据疾病的不同阶段和证候,辨证、分期论治。其中,健脾益肾以治本,益气养阴清热或化痰祛瘀以治标,临床疗效显著。文章总结高瞻教授对“雄激素剥夺治疗后代谢并发症”中医病因病机的认识以及辨证论治经验、用药特色,以期为临床治疗提供参考。"Androgen deprivation of metabolic complications"is a common clinical complication of androgen deprivation therapy in metastatic prostate cancer,affecting quality of life and overall survival while controlling tumors.Under the guidance of Synopsis of Golden Chamber,Gao Zhan thought that"androgen deprivation of metabolic complications"should be treated from"consumptive disease"and the disease is caused by medicine,and the main pathogenesis was"deficiency of spleen and kidney",and the main pathologic factor was phlegm and blood stasis.In terms of treatment,the method of"invigorating the spleen and kidney"is established.The self-designed"Jianpi Yishen Recipe"is taken as the basic prescription,and treatment is based on syndrome differentiation and stages according to different stages and syndromes of the disease.In the course of treatment,spleen and kidney should be invigorated to cure the root cause,Qi and Yin should be enhanced to clear heat,or phlegm and blood stasis should be eliminated to treat the symptoms with significant clinical effect.This paper summarized Gao Zhan’s understanding of the pathogenesis of"androgen deprivation of metabolic complications"and his experience in the treatment based on syndrome differentiation,as well as the specific characteristics of medication,so as to provide references for clinical treatment.

关 键 词：高瞻 雄激素剥夺治疗后代谢并发症 虚劳 健脾益肾方 临床经验 

分 类 号：R285[医药卫生—中药学]