侯爱画基于“扶正祛邪”理论治疗肺癌恶性胸腔积液经验  

Hou Aihua's experience in the treatment of malignant pleural effusions in lung cancer based on the theory of"strengthening vital qi and eliminating pathogens"

作　　者：王承祥 侯爱画 孟鹏 刘泽 赵啸虎 程雪云 刘静璇 WANG Chengxiang;HOU Aihua;MENG Peng;LIU Ze;ZHAO Xiaohu;CHENG Xueyun;LIU Jingxuan(Shandong University of Traditional Chinese Medicine,Jinan 250355,China;Department of Oncology,Yantai Hospital of Traditional Chinese Medicine,Yantai 264001,China)

机构地区：[1]山东中医药大学,济南250355 [2]烟台市中医医院肿瘤科,山东烟台264001

出　　处：《吉林中医药》2025年第1期55-59,共5页Jilin Journal of Chinese Medicine

基　　金：第七批全国老中医药专家学术经验继承项目(国中医药人教函〔2022〕76号);全国名老中医药专家传承工作室(国中医药人教函〔2018〕134号);山东省名老中医药专家传承工作室(鲁卫函〔2019〕92号);山东省中医药科技项目(M-2023096)。

摘　　要：恶性胸腔积液(malignant pleural effusion,MPE)是肺腺癌晚期常见并发症之一,严重影响疾病的治疗与患者的生活质量,预后较差。侯爱画教授基于“扶正祛邪”治疗思想,认为肺癌恶性胸腔积液正虚为根本,浊毒内盛为外在表现,根据“本虚标实”的病机,从“虚”“浊”对恶性胸腔积液进行论治,以“君、臣、佐、使、援”组方,提出温阳补虚、化浊祛邪、泻肺平喘相结合的治疗原则。扶本脏之正的同时要防他脏之虚,不仅要攻痰浊之邪,亦要攻癌毒之邪,加以理气活血,巧用援药,将“邪去正自安”与“养正积自除”的辨证思想结合,平衡“扶正”与“祛邪”的关系,临床疗效良好。Malignant pleural effusion(MPE)is one of the common complications of advanced lung adenocarcinoma,which seriously affects the disease treatment and the life quality of patients and whose prognosis is poor.Based on the therapeutic thought of"strengthening the body resistance and eliminating pathogenic factors",Professor Hou Aihua believes that the root cause of MPE in lung cancer features the deficiency of vital qi,and its manifestation lies in the internal exuberance of turbid toxins.According to its pathogenesis of"deficiency in root cause and excess in manifestation",he treats MPE from the two aspects of"deficiency"and"turbidity".Under the prescription and medication guidance of"monarch,minister,assistant,envoy and aid",he advocates the treatment principle of integrating warming yang and tonifying deficiency,resolving turbidity and dispelling pathogens,and purging the lungs and relieving asthma.As the saying"where a pathogen is gathered,qi of an organ will be deficient"goes,in the process of reinforcing the healthy qi of a zang-organ,it is necessary to prevent deficiency in other zangorgans.In the process of attacking pathogens,it is not only necessary to eliminate phlegm turbidity,but also to remove cancer toxins,to regulate qi and activate blood.In his treatment of MPE in lung cancer,he employs aid medicines skillfully,combining dialectically"eliminating pathogenic factors to strengthen vital qi"with"nourishing healthy qi to eliminate pathogenic factors",striking a balance between"strengthening healthy qi"and"eliminating pathogenic factors",so as to attain remarkable clinical efficacy.

关 键 词：恶性胸腔积液 肺癌 援药 名医经验 侯爱画 

分 类 号：R734.2[医药卫生—肿瘤]