名中医王瑞平“期证相合”理论在肺癌术后研究肿瘤微环境经验  

Wang Ruiping’s theory of“phase correspondence”in postoperative lung cancer patients

作　　者：宁永波 王雅兴 陈香颖 陈嘉齐 吴存恩 王瑞平 NING Yongbo;WANG Yaxing;CHEN Xiangying;CHEN Jiaqi;WU Cun’en;WANG Ruiping(Department of Medical Oncology,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210004,China)

机构地区：[1]南京中医药大学附属医院肿瘤内科,江苏南京210004

出　　处：《陕西中医》2023年第10期1448-1451,共4页Shaanxi Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金资助项目(82104950);江苏省中医院院级课题(Y2020CX67)。

摘　　要：王瑞平教授根据多年的临床经验将肺癌术后病理变化归结为正虚与邪实相争,正虚责于脾肺气虚,邪实则为术后残留之癌毒与用药稽留之药毒,二者常与血瘀、痰热、水湿等病理因素交结攻伐人体,而致正气虚,邪气盛。王教授认为一病多期是肺癌术后的基本病理状态,根据术后临床表现与癌毒动态变化可分为毒留期、毒郁期、毒恋期,并与肺癌术后瘀阻毒炽、痰热毒聚、正虚毒结证相合诊疗。治疗时权衡标本虚实之轻重,遵循“急攻缓补”的治疗原则,酌情施以化瘀、清热、补虚之法并将补脾益肺与抗癌解毒贯穿治疗始终,从而改善“血液高凝”“炎-癌转化”“免疫抑制”相关肿瘤微环境,提高术后患者生活质量,延长术后生存期。Based on years of clinical experience,Prof.Wang Ruiping attributed the postoperative pathological changes of lung cancer to the competition between positive deficiency and evil reality.The positive deficiency is attributed to the deficiency of spleen and lung qi,while the evil reality is the cancer toxicity left after surgery and the drug toxicity retained by drugs.According to Prof.Wang,multiple stages of lung cancer is the basic pathological state after lung cancer surgery,which can be divided into toxic retention stage,toxic depression stage and toxic love stage according to postoperative clinical manifestations and dynamic changes of cancer toxicity,and combined with postoperative lung cancer stasis and toxic incandescence,phlegm-heat and toxic gathering,and positive deficiency and toxic love.The treatment is based on the principle of“urgent attack and slow remedy”,and the methods of resolving blood stasis,clearing heat,and tonifying deficiency are applied as appropriate,the treatment is based on tonifying the spleen and benefiting the lung and detoxifying the cancer,it can improve the microenvironment of tumor related to“blood hypercoagulation”,“inflammation-cancer transformation”and“immunosuppression”,improve patients’postoperative quality of life and prolong their survival.

关 键 词：肺癌 术后分期 肿瘤微环境 癌毒 辨证论治 

分 类 号：R734.2[医药卫生—肿瘤]