浅谈小青龙合葶苈大枣泻肺汤加减治疗肺癌引发的恶性胸腔积液  

A discussion on modified Xiaoqinglong decoction combined with Tingli Dazao Xiefei decoction in the treatment of lung cancer-associated malignant pleural effusion

作　　者：赵子晋 郑凯[2] ZHAO Zijin;ZHENG Kai

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《中医临床研究》2024年第24期65-68,共4页Clinical Journal Of Chinese Medicine

摘　　要：肺癌伴恶性胸腔积液是肺癌晚期患者常出现的并发症之一,难治愈,易复发,严重影响患者的生存质量。西医以胸腔穿刺抽液术及置管引流术、胸膜固定术、胸腔热灌注疗法、胸膜内灌注疗法(化疗药物、生物反应调节剂)、抗血管生成药物(贝伐单抗、重组人血管内皮生长因子抑制剂)、载药微粒为主要治疗手段。中医治疗本病通常以中药汤剂口服、中药穴位贴敷、中药制剂注射以及针灸治疗为主。文章主要对中药汤剂小青龙汤、葶苈大枣泻肺汤的中药功效及西医药理作用等进行系统分析,阐述二者合方对肺癌引发的恶性胸腔积液的治疗效果。中医上因本病病位在胸胁,故诊断为悬饮,辨证为饮停胸胁证,治则上以温阳宣肺利水法为主,辅以扶正抗癌,整体调节,辨证论治,运用小青龙合葶苈大枣泻肺汤加减治疗。小青龙汤、葶苈大枣泻肺汤作为《伤寒杂病论》的著名方剂,临床应用于治疗支气管哮喘、慢性阻塞性肺疾病、心力衰竭、胸腔积液、恶性肿瘤等疾病,效果显著。文章主要采用小青龙合葶苈大枣泻肺汤加减治疗肺癌引发的恶性胸腔积液,治疗效果满意,减轻了患者的痛苦,提高了患者的生活质量,为肺癌引发的恶性胸腔积液的后期临床诊断和治疗提供了思路。Lung cancer-associated malignant pleural effusion is a frequently encountered complication in advanced-stage lung cancer patients,which is difficult to cure and easy to relapse,and seriously affects the quality of life of patients.In Western medicine,thoracic aspiration and drainage,pleuropexy,thoracic thermoperfusion,intrapleural perfusion(chemotherapeutic drugs,biological response modulators),anti-angiogenic drugs(bevacizumab,recombinant human vascular endothelial growth factor inhibitors)and drug-loaded particles are the main treatment methods.Traditional Chinese medicine treatment is usually based on oral administration of traditional Chinese medicine decoction,acupoint application of traditional Chinese medicine,injection of traditional Chinese medicine preparation and acupuncture.In this paper,the efficacy of traditional Chinese medicine and pharmacological action of Western medicine of Xiaoqinglong decoction(小青龙汤)and Tingli Dazao Xiefei decoction(葶苈大枣泻肺汤)are systematically analyzed,and the therapeutic effect on lung cancer-associated malignant pleural effusion is expounded.In traditional Chinese medicine,its pathologic location is in the thoracoabdominal region,hence it is identified as“retention of body fluid”,the syndrome differentiation is“fluid stasis in the thoracoabdominal region”.The main therapeutic principles are warming Yang(阳),promoting lung and clearing dampness,which is supplemented by reinforcing the vital energy and anticancer,overall regulation,syndrome differentiation and treatment.Modified Xiaoqinglong decoction combined with Tingli Dazao Xiefei decoction is used in the treatment of lung cancer-associated malignant pleural effusion.Xiaoqinglong decoction and Tingli Dazao Xiefei decoction are well-known prescriptions from the classical Chinese medical texts of Shanghan Zabing Lun(《伤寒杂病论》),are used in the treatment of bronchial asthma,chronic obstructive pulmonary disease,heart failure,pleural effusion,malignant tumor and other diseases clinical

关 键 词：恶性胸腔积液 小青龙汤 葶苈大枣泻肺汤 温阳宣肺利水 扶正抗癌 

分 类 号：R273[医药卫生—中西医结合]