癌性发热病因病机及论治的研究进展  

Research Progress in the Etiology,Pathogenesis,and Treatment of Cancerous Fever

作　　者：习弯弯 谷宁[2] 徐羽[2] 李志刚[2] XI Wanwan;GU Ning;XU Yu;LI Zhigang(Henan University of Chinese Medicine,Zhengzhou 450046,China;The Third Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学,郑州450046 [2]河南中医药大学第三附属医院,郑州450003

出　　处：《世界中医药》2024年第8期1197-1202,共6页World Chinese Medicine

基　　金：全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号);河南省中医药科学研究专项课题(20-21ZY2076)。

摘　　要：基于大量中西医文献研究,癌性发热为恶性肿瘤发生发展及治疗过程中癌组织本身释放的多种病理因子所致的非感染性发热,病情演变与肿瘤的消长相关,控癌是治疗的关键。中医病机为郁、虚、毒、瘀等或交织为病,郁多为气郁、湿郁,前者治以调畅肝气、清热泻火;后者结合虚实清热利湿、通腑泻浊或健脾升阳、化浊除湿。因虚发热,以气虚、阴虚或气阴两虚多见,治以甘温除热、滋阴清热、益气养阴。正虚内生癌毒,侵袭流注、耗伤正气,湿、瘀互结成痰形成实质肿块,脏腑功能失调蒸酿而成痰毒,毒邪内蕴,耗气伤血损津,“毒”既是致病因素也是病理产物。手术、化放疗、靶向及免疫治疗的不良反应以“外邪”与癌毒相裹挟,加重毒聚之势,耗正气伤精血,治以清热解毒、扶正祛邪。瘀分虚实,实则气血瘀滞于经脉化热,治以活血祛瘀清热;虚则阴血亏虚,瘀滞经脉,治以养阴化瘀退热。基于病机辨证也可辅以针刺、中药穴位贴敷等疗法,控制热势后要着眼于癌病本身以防病复。According to the available studies of both TCM and Western medicine,cancerous fever is a non-infectious fever caused by pathological factors released by the tumor tissue during the occurrence,development,and treatment of malignant tumors.The evolution of the condition is related to the growth and decline of the tumor,and cancer control is the key to treatment.The TCM pathogenesis of cancerous fever is characterized by stagnation,deficiency,toxin,stasis,or their combinations.The patients with stagnation mainly present qi stagnation or dampness stagnation.The former is treated by regulating liver qi,clearing heat,and purging fire,and the latter by clearing heat and draining dampness,relaxing bowels and discharging turbidity or invigorating spleen and elevating yang,resolving turbidity and removing dampness according to excess or deficient syndromes.The patients with deficiency mainly present qi deficiency,yin deficiency,or both qi and yin deficiency.In the treatment of these patients,sweet and warm medicines can be used to eliminate heat,and methods such as nourishing yin,clearing heat,and replenishing qi,can be adopted.The deficiency of healthy qi leads to the generation of cancer toxin,which consumes healthy qi,causing dampness and stasis to form phlegm and solid mass.The dysfunction of zang-fu organs leads to the formation of phlegm and toxin through steaming.The internal accumulation of toxin and pathogen consumes qi,blood,and body fluid.Toxin is not only a pathogenic factor but also a pathological product.The toxic side effects induced by surgery,chemotherapy,radiotherapy,targeted therapy,and immunotherapy,combined with the external pathogen and cancer toxin,exacerbate the accumulation of toxin,consuming healthy qi and damaging essence and blood.Accordingly,the treatment should aim to clear heat,remove toxin,reinforce healthy qi,and eliminate pathogen.Stasis is caused by deficiency or excess.In the case of excess,qi and blood stasis stagnate in the meridians and transform into heat,which should be treated by a

关 键 词：癌性发热 郁 虚 毒 瘀 论治 进展 

分 类 号：R273[医药卫生—中西医结合]