肺癌合并血液高凝状态及中医活血化瘀法对其干预的研究进展  

A review on lung cancer with blood hypercoagulability and its TCM intervention of promoting blood circulation and removing blood stasis

作　　者：刘敏 LIU Min

机构地区：[1]淮安市中医院,江苏淮安223001

出　　处：《中医临床研究》2022年第36期77-81,共5页Clinical Journal Of Chinese Medicine

摘　　要：肺癌作为发病率和病死率最高的恶性肿瘤,临床上常合并血液高凝状态。高凝状态指的是多种病理因素作用下引起的机体血管内皮细胞功能受损、凝血、纤溶/抗凝系统功能紊乱,引起血液凝固性增高,易于形成血栓的病理状态。它不仅可促进血栓形成,同时影响肺癌的发生发展、转移及预后。多项指标可反映其高凝状态,如血浆纤维蛋白原(Fibrinogen,FIB)、血浆D-二聚体(D-dimer,D-D)、血小板计数(Platelet Count,PLT)、血栓弹力图(Thrombelastograghy,TEG)等。对于肺癌合并高凝状态,西医常应用抗凝治疗。中医从血瘀证出发,认为血瘀是恶性肿瘤发生与进展的重要病因与病机过程,而血瘀的临床表现与恶性肿瘤并发血液高凝状态的特征基本一致。大量研究表明,根据辨证论治采取以活血化瘀法为中心的治则,能够有效缓解临床症状,改善患者的血液高凝状态。因此临床治疗上,针对肺癌合并高凝状态,应结合现代的血液学检测,及时进行干预。不仅可以给予传统的抗凝治疗,同时可以根据辨证论治的原则合理地应用中医活血化瘀法,以达到缓解症状、改善预后的效果。同时,期待更多中医方面以循证医学为指导、多中心、大数据的研究成果,为临床中医药治疗肺癌合并高凝状态提供更充分的理论依据。The incidence rate and death rate of lung cancer is the highest,and it is often associated with hyper-coagulable state.Hyper-coagulable state refers to the pathological state that the function of vascular endothelial cells is damaged,the function of coagulation and fibrinolysis/anticoagulation system is disordered,resulting in increased blood coagulation and easy thrombosis under the action of a variety of pathological factors.It not only promotes thrombosis,but also affects the occurrence,development,metastasis and prognosis of lung cancer.Many indexes can reflect its hyper-coagulable state,such as plasma fibrinogen(FIB),plasma D-Dimer(D-dimer),platelet count(PLT),thromboelastography(TEG).For lung cancer with hyper-coagulable state,anticoagulant therapy is often used clinically.Based on the syndrome differentiation and blood stasis syndrome,traditional Chinese medicine believes that blood stasis is an important etiology and pathogenesis process of the occurrence and progress of malignant tumors,and that the clinical manifestations of blood stasis are basically consistent with the characteristics of malignant tumors with hyper-coagulability.There is plenty of research showing that traditional Chinese medicine adopts the principle of activating blood circulation and removing blood stasis,and can effectively relieve the clinical symptoms and improve the hyper-coagulable state of patients.Therefore,in clinical treatment,for lung cancer with hyper-coagulable state,timely intervention should be combined with modern hematological testing.We can not only give traditional anticoagulant therapy,but also reasonably apply the method of promoting blood circulation and removing blood stasis according to the principle of syndrome differentiation,so as to alleviate symptoms and improve prognosis.At the same time,we look forward to more research results of TCM under the guidance of evidence-based medicine,multi center and big data,so as to provide a more sufficient theoretical basis for clinical TCM treatment of lung cancer with

关 键 词：肺癌 血液高凝状态 中医 活血化瘀 

分 类 号：R273[医药卫生—中西医结合]