从形神理论探讨乳腺癌并焦虑的辨治思路  

Discussion on the differentiation and treatment of breast cancer with anxiety through the lens of the Body and Spirit theory

作　　者：张琼[1,2] 焦烁颖 楚爱景 裴晓华 ZHANG Qiong;JIAO Shuoying;CHU Aijing;PEI Xiaohua(Beijing University of Chinese Medicine,Beijing 100029;Department of Breast,The Third Affiliated Hospital of Beijing University of Chinese Medicine;Department of Thoracic and Breast Surgery,Xiamen Hospital,Beijing University of Chinese Medicine)

机构地区：[1]北京中医药大学,北京100029 [2]北京中医药大学第三附属医院乳腺科 [3]北京中医药大学厦门医院乳腺科

出　　处：《现代中医临床》2024年第6期1-4,共4页Modern Chinese Clinical Medicine

基　　金：国家自然科学基金项目(No.82374463)。

摘　　要：形神失调是乳腺癌并焦虑病因病机之根本,乳腺癌之“形损”与焦虑之“神伤”,源于五脏失和,神不得藏。由“神伤”到“形损”,始因于肝,神失所达,神伤而不舍形。“形损”加重“神伤”,阳浮神动,神不得安,根因于肾;土虚火炎,神无所养,其因在脾;脏不舍神,神无所定,责之于心;治节失权,神无所充,因机于肺。治疗上,分阶段进行“形神同调”论治乳腺癌并焦虑。乳腺癌癌前阶段或确诊后带瘤状态,以调肝木、健脾土为主;乳腺癌术后综合治疗、新辅助治疗期间,滋肾水、培脾土、消心火、畅肝肺。随症变通,标本兼治。并结合临床案例阐述从形神理论辨治乳腺癌并焦虑的思路。The disorder of body and spirit is the fundamental etiology and pathogenesis of breast cancer with anxiety.The“body damage”in breast cancer and the“spirit injury”in anxiety stem from disharmony of the five zang organs,where the spirit cannot be properly contained.The progression from“spirit injury”to“body damage”begins with the liver,where the spirit loses its normal flow and becomes injured,failing to protect the body.The exacerbation of“body damage”further aggravates“spirit injury”,as yang rises and the spirit becomes unsettled,with the root cause traced back to the kidney.A deficiency of spleen earth and excess heart fire prevent the spirit from receiving nourishment,while the heart and lung contribute to further dysfunction in this complex interaction.In terms of treatment,the concept of“harmonizing body and spirit”is applied in stages.The focus is on using the spirit to heal the form and the form to nourish the spirit.During the precancerous stage or in the tumor-bearing state after diagnosis,treatment emphasizes regulating the liver and strengthening the spleen.During postoperative comprehensive treatment and neoadjuvant therapy,the focus shifts to nourishing kidney water,supporting spleen earth,clearing heart fire,and promoting smooth Qi movement in the liver and lungs.The formula should be adjusted according to symptoms and the key is to address both the root cause and clinical manifestations.This paper explains the differentiation and treatment of breast cancer with anxiety through the lens of the Body and Spirit theory with case reports.

关 键 词：乳腺癌 焦虑 形神理论 五脏失和 防夏地黄方 

分 类 号：R273[医药卫生—中西医结合] R256.28[医药卫生—中医肿瘤科]