刍议《医林改错》学术思想在肺癌诊疗中的应用  

The Application of the Academic Idea of“Yilin Gaicuo”in the Diagnosis and Treatment of Lung Cancer

作　　者：朱乐 张亚茹 袁苏云 王理槐[2] 张红[2] ZHU Le;ZHANG Yaru;YUAN Suyun;WANG Lihuai;ZHANG Hong(Hunan University of Chinese Medicine Hunan Changsha 410208,China;The First Affiliated Hospital of Hunan University of Chinese Medicine Hunan Changsha 410007,China)

机构地区：[1]湖南中医药大学,湖南长沙410208 [2]湖南中医药大学第一附属医院,湖南长沙410007

出　　处：《中医药临床杂志》2023年第7期1290-1293,共4页Clinical Journal of Traditional Chinese Medicine

基　　金：2021年省自然科学基金(2021JJ30525);2020湖南省科技创新计划项目(2020SK51405)。

摘　　要：肺癌是威胁人类健康的一类慢性非传染性疾病,是呼吸系统最为常见的恶性肿瘤,在中国,其发病率和病死率常年居高不下,给社会和经济发展造成了沉重的医疗负担。目前,肺癌的治疗手段多样,主要有外科手术、放疗、化疗、免疫和靶向治疗等,虽然逐渐延长了患者的生存时间,但由于治疗中不良反应的产生以及治疗后复发转移的出现,大多数患者的生存质量及远期疗效并不理想。中国传统医学强调“整体观念”,从“证候”入手,在肺癌的诊疗方面具备独特优势,得到了全社会广泛的关注跟认可。《医林改错》为清代医家王清任通过总结42年的实践及临床经验所得,并刊行于1830年的唯一传世之书。全书共计三万余字,分有上下二卷,上卷内容又分为两部分,其一为他对前人在脏腑解剖及生理功能方面一些矛盾认知的辨析,不仅提出了自己的新认识,并根据自身观察绘制了相关图谱与古人的图谱进行比对;其二为通窍活血汤、血府逐瘀汤以及膈下逐瘀汤三首方剂分治人体外周、胸中、肚腹血瘀之症的临床应用。下卷则论述了临床诸症的气血病机、诊疗以及自创方剂的相关应用。王清任在《医林改错》中革新脏腑及生理认知、继承与发扬气血理论、充实完善了血瘀学说,并创立了一系列在临床实践中行之有效的活血化瘀方,其独特的理法方药体系在肺癌的中医诊疗应用中大有可为。Lung cancer is a chronic non-communicable disease that threatens human health.It is the most common malignant tumor of the respiratory system.In China,its morbidity and mortality remain high all year round,causing a heavy medical burden on social and economic development.At present,there are various treatment methods for lung cancer,mainly including surgery,radiotherapy,chemotherapy,immunization and targeted therapy.The quality of life and long-term efficacy of most patients are not ideal.Traditional Chinese medicine emphasizes the“holistic concept”and starts with“syndrome”.It has unique advantages in the diagnosis and treatment of lung cancer,and has been widely concerned and recognized by the whole society.“Yilin Gaicuo”is the only handed down book published in 1830,obtained by summarizing 42 years of practice and clinical experience by WANG Qingren,a physician in the Qing Dynasty.The book has a total of more than 30,000 words and is divided into two volumes.The first volume is divided into two parts.The first part is his analysis of some contradictory cognitions of the predecessors on viscera anatomy and physiological functions.He not only puts forward his own new understanding,and draw the relevant atlas according to their own observations for comparison with those of the ancients;the second is Tongqiao Huoxue decoction,Xuefu Zhuyu decoction and Gexia Zhuyu decoction to treat blood stasis in the periphery,chest and abdomen of the human body.clinical application of disease.The second volume discusses the pathogenesis,diagnosis and treatment of Qi and blood in various clinical diseases,as well as the related application of self-created prescriptions.WANG Qingren innovated viscera and physiological cognition,inherited and carried forward the theory of Qi and blood,enriched and perfected the theory of blood stasis in“Yilin Gaicuo”,and created a series of effective blood circulation and blood stasis prescriptions in clinical practice.His unique The system of theory,method and prescription has great

关 键 词：《医林改错》 肺癌 医家思想 王清任 活血化瘀 

分 类 号：R273[医药卫生—中西医结合]