基于“三焦气化”理论探讨恶性胸腔积液的证治  

Pattern differentiation and treatment of malignant pleural effusion based on the theory of "qi transformation in sanjiao"

作　　者：刘艳霞 杨鹏斐[2] 姜建东 戴安伟[1] 顾展丞 LIU Yanxia;YANG Pengfei;JIANG Jiandong;DAI Anwei;GU Zhancheng(Kunshan Hospital of Chinese Medicine,Kunshan,Jiangsu 215300,China;Gansu University of Chinese Medicine,Lanzhou,Gansu 730000,China)

机构地区：[1]昆山市中医医院,江苏昆山215300 [2]甘肃中医药大学,甘肃兰州730000

出　　处：《湖南中医药大学学报》2024年第9期1677-1681,共5页Journal of Hunan University of Chinese Medicine

基　　金：江苏省中医药科技发展计划项目(QN202324)。

摘　　要：恶性胸腔积液为肿瘤晚期常见并发症,目前的治疗策略有限且难以根治。中医学将其归属于“悬饮”“支饮”范畴。“三焦气化”理论指机体气血津液在上、中、下三焦输布代谢的气机变化。三焦气化失司是恶性胸腔积液的根本病机,通调三焦、益气温阳贯穿恶性胸腔积液治疗全过程,治疗时应根据病变原因和病变部位之不同,宣肃肺气以理上焦、健运脾气以治中焦、温补肾气以调下焦,以求扼其恶性、截饮之源。附医案一则加以阐明。Malignant pleural effusion(MPE) is a common complication in the advanced stage of cancers,and it is difficult to cure it with limited treatment strategies currently.In Chinese medicine,it is categorized as "pleural fluid retention" and "thoracic fluid retention".The theory of "qi transformation in sanjiao" indicates the changes in the circulation and metabolism of blood,qi,and body fluids in the upper,middle,and lower jiao.The dysfunction of qi transformation in sanjiao is the underlying pathological mechanism of MPE.The principles of regulating sanjiao and supplementing qi and warming yang should be applied throughout the treatment course of MPE.The treatment should be tailored to distinct pathological causes and locations,i.e.dispersing the lung qi to adjust the upper jiao,strengthening and circulating the spleen qi to treat the middle jiao,and warming and tonifying the kidney qi to regulate the lower jiao,in order to curb the malignancy and cut off the source of fluid retention.A medical record is presented as an example to illustrate.

关 键 词：恶性胸腔积液 三焦气化 温补阳气 调理三焦 

分 类 号：R255.8[医药卫生—中医内科学]