癌性发热的中医辨证治疗  

TCM syndrome differentiation and treatment of cancer fever

作　　者：王泽文 王振强[2] WANG Zewen;WANG Zhenqiang

机构地区：[1]承德医学院,河北承德067000 [2]河北省沧州中西医结合医院,河北沧州061000

出　　处：《中医临床研究》2024年第6期70-74,共5页Clinical Journal Of Chinese Medicine

摘　　要：癌性发热是指肿瘤患者在排除感染等情况下出现的肿瘤本身引起的或因治疗引起的发热,目前现代医学对于癌性发热并无特殊治疗方法,一般会选用非甾体类抗炎药或激素类药物,但这两类药物易出现水钠潴留、胃肠道反应等,影响患者的生存质量,不宜长期使用。应用中医辨证的方式治疗癌性发热为临床治疗提供了另一个思路。中医将癌性发热归为“内伤发热”的范畴,早在《黄帝内经》中已有关于内伤发热的记载,且其中明确提出了“诸寒之而热者,取之阴”的治疗原则。后世医家在此基础上也创立了许多行之有效的治疗内伤发热的经典方剂,仍被广泛使用。中医可将癌性发热分为虚实两方面,虚证患者可分为气虚发热、阴虚发热、阳虚发热和复合证型导致虚证发热,因正气亏虚,所以在治疗上要以补虚为主,兼以益气、滋阴、补阳,顾护脾胃。实证患者热势较盛,可适当应用寒凉药物清热泻火。临床上可将实证癌性发热患者分为热毒炽盛证、痰湿内蕴证、血瘀发热证等证型,在治疗上应以清热为主,兼以泻火解毒、燥湿化痰、活血化瘀等。癌性发热患者临床上并不少见,如何减轻症状,提高患者生存质量,需要我们在临床上不断总结、归纳。Cancer fever refers to the fever caused by the tumor itself or due to treatment in the case of excluding infection.At present,modern medicine has no special treatment for cancer fever,and generally applies non-steroidal anti-inflammatory drugs or hormone drugs,but these two drugs are prone to water and sodium retention,gastrointestinal reactions,etc.,affecting the quality of life of patients,and is not suitable for long-term use.The application of TCM syndrome differentiation in the treatment of cancer fever provides another idea for clinical treatment.In TCM,cancer fever can be classified as“fever of internal injury”,which has been recorded as early as in Huangdi Neijing(《黄帝内经》),and the treatment principle of“When cold medicine aggravates the heat syndrome,the method of nourishing Yin(阴)and tonifying kidney should be used clinically”was clearly put forward in this book.On this basis,later generations of physicians have also created many effective classical prescriptions for the treatment of internal injury fever,which are still widely used TCM divides cancer fever into two types,deficiency fever and excess fever.Deficiency fever can be divided into Qi(气)deficiency fever,Yin deficiency fever,Yang(阳)deficiency fever and compound type of deficiency fever due to the deficiency of positive Qi,so the treatment should be mainly to replenish deficiency,and at the same time to invigorate Qi,nourish Yin,replenish Yang,and care for the spleen and stomach.The excess patients’heat potential is more intense,and cold drugs can be appropriately used to clear the heat and purge fire.Clinically,patients with excess cancer fever can be divided into the heat toxicity syndrome,phlegm-dampness syndrome,blood stasis fever syndrome,etc.The treatment should focus on clearing heat,combined with the methods of purging fire for detoxification,drying dampness and eliminating phlegm,and promoting blood circulation and removing blood stasis.Cancer fever is not uncommon in patients clinically,and how to relieve the

关 键 词：癌性发热 中医 辨证 治疗 肿瘤 

分 类 号：R273[医药卫生—中西医结合]