中医古籍文献中骨与软组织肿瘤诊治规律的探讨  

Study on the Regularities of Diagnosis and Treatment of Bone and Soft Tissue Tumors in Ancient Chinese Medical Literature

作　　者：蒋林亨 郑嘉乾 周楠楠 易春智[3] 何敏聪 蓝鋆 李若愚 方斌[3] JIANG Lin-Heng;ZHENG Jia-Qian;ZHOU Nan-Nan;YI Chun-Zhi;HE Min-Cong;LAN Yun;LI Ruo-Yu;FANG Bin(The First Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;South China University of Technology,Guangzhou 510006 Guangdong,China;Dept.of Bone Tumors,the First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Guangdong Provincial Institute of Orthopedics and Traumatology of Chinese Medicine,Guangzhou 510120 Guangdong,China;The Third Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510378 Guangdong,China)

机构地区：[1]广州中医药大学第一临床医学院,广东广州510405 [2]华南理工大学,广东广州510006 [3]广州中医药大学第一附属医院骨肿瘤科,广东广州510405 [4]广东省中医骨伤研究院,广东广州1510120 [5]广州中医药大学第三附属医院,广东广州510378

出　　处：《广州中医药大学学报》2023年第3期755-760,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(编号:82004392);广东省教育厅高校科研项目青年创新人才项目(编号:2019KQNCX017);广州中医药大学第一附属医院“创新强院”工程项目(编号:2019ⅡT28)。

摘　　要：【目的】检索骨与软组织肿瘤的相关古籍文献,探讨古代医者诊治骨与软组织肿瘤的规律。【方法】以“石瘤”“骨瘤”“肉瘤”“石痈”“石疽”为检索词,检索博览医书中医古籍文献数据库、《中华医典》、中国知网古籍数据库有关骨与软组织肿瘤的病症、病机、治法、方药、预后、禁忌症等内容,分析其诊治规律。【结果】共检索了82部古籍,纳入相关条文137条。明确记载肿块疼痛的有19条,肿块未感疼痛的有31条,记载肿块进行性生长的条文有39条;涉及病机的条文有83条;119条明确记载了治法方药。有关治法方药的条文中,内服汤剂69条,灸法16条,敷药63条,部分条文涉及汤药、灸法、敷药等多种治疗方式。出现频次较高的方剂有破结散、调元肾气丸、陷肿散、阳和汤、归脾汤等。此外,条文提及该病预后不良,需重视精神调护,并将针刀治疗视为禁忌。【结论】古籍文献资料发掘的骨与软组织肿瘤的诊治规律如下:病机特点为虚实夹杂,或各种病机交错复合出现,病位主要涉及肝、肾、脾三脏;治法多样,基于辨病治疗与辨证治疗;其预后不良,禁用针刀治疗。发掘得到的诊治规律可为现代中西医结合诊治骨与软组织肿瘤提供参考。Objective To search the relevant ancient literature on bone and soft tissue tumors and to explore the regularities of diagnosis and treatment of bone and soft tissue tumors by ancient medical practitioners. Methods With stone-like tumors,bone tumors,muscle tumors,stone-like abscess and stone-like gangrene as the key words,the symptoms,pathogenesis,therapies,prescriptions,prognosis and contraindications of bone and soft tissue tumors were retrieved from the database of ancient traditional Chinese Medicine books of iMedbooks,Collection of Traditional Chinese Medical Books and the database of ancient books of CNKI, and then the regularities of diagnosis and treatment of bone and soft tissue tumors were analyzed. Results A total of 82 ancient books were retrieved and 137 articles were included. Of the 137 articles,19 articles explicitly stated that the lump was painful,31 articles stated that the lump was not painful,and 39 articles stated that the lump was growing progressively;83 articles dealt with the pathogenesis of the disease;119 articles explicitly stated the therapies and prescriptions. Among the articles about therapies and prescriptions, there are 69 articles about oral administration of decoction, 16 articles about moxibustion, and 63 articles about the external application of Chinese medicine;some of the articles involved a variety of therapies including herbal decoction,moxibustion and external application of Chinese medicine. The high-frequency prescriptions included Pojie Powder,Tiaoyuan Shenqi Pills, Xianzhong Powder, Yanghe Decoction and Guipi Decoction. In addition, some of the articles mentioned the poor prognosis of the disease and the importance of spiritual care,and acupotomy was prohibited.Conclusion The regularities of diagnosis and treatment of bone and soft tissue tumors uncovered from the ancient literature are as follows: the pathogenesis is characterized by a mixture of deficiency and excess, or the complication of various pathogenesis, and the location of the disease mainly involves the

关 键 词：骨与软组织肿瘤 中医古籍 病机 治法 方药 预后 

分 类 号：R273.8[医药卫生—中西医结合]