老年人肿瘤的中西医协同治疗策略  

Synergistic treatment strategies of Chinese and Western medicine among elderly cancer patients

作　　者：黄飞[1] 闫晓光[1] 陈雨 李文瑞[1] Huang Fei;Yan Xiaoguang;Chen Yu;Li Wenrui(Department of Traditional Chinese Medicine,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院中医科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730

出　　处：《中华老年医学杂志》2025年第3期283-288,共6页Chinese Journal of Geriatrics

摘　　要：老年人肿瘤的发病率高,危害性大,病情复杂,治疗难度大,诊疗过程缺乏确切的临床依据及试验证据,导致治疗面临诸多困局,容易陷入进退两难的困境。中西医协同、取长补短,可以很大程度上破除困局,以确保老年肿瘤患者能承受系统、全面、高负荷的肿瘤治疗,中医药可以全程参与老年肿瘤患者的治疗过程,积极发挥或主、或从、或辅、或先、或后的各类作用。本文借用中医"正"、"邪"概念,"正"代表"人的状态"、"邪"表示"肿瘤的状态",并依据两种状态的不同,分别从正强邪盛、正盛邪弱、正虚邪盛、正虚邪弱这4种情形,系统讨论老年人肿瘤的中西医协同治疗策略。正强邪盛,采用西医主导,中医药全程辅助的治疗策略;正盛邪弱,中西医协同的治疗策略是治疗早期西医主导,治疗后期中医主导;正虚邪盛,此状态的中西医协同治疗策略为中医主导或中西并重;正虚邪弱,中西医协同的治疗策略为中医为先导,贯穿始终,西医随机应变,看准时机,精准介入。通过准确判断"正"、"邪"状态,采用相应的中西医协同治疗策略,可以显著调整老年肿瘤患者的身体状态,提高免疫力,改善脏器功能,提升肿瘤治疗的承受力,缓解并发症,减轻不良反应,确保老年肿瘤患者能最大程度完成肿瘤的系统治疗,改善预后,提高生活质量,延长有效生存期。The incidence of tumors among the elderly is notably high,presenting significant challenges in terms of harm,complexity,and treatment.The processes of diagnosis and treatment often lack a precise clinical foundation and robust experimental evidence,resulting in numerous difficulties and dilemmas.A collaborative approach that integrates traditional Chinese and Western medicine,leveraging the strengths of both,can substantially alleviate these challenges and ensure that elderly cancer patients can undergo systematic,comprehensive,and intensive cancer treatments.Traditional Chinese medicine can play a vital role throughout the entire continuum of diagnosis and treatment for elderly cancer patients,whether by leading,assisting,or complementing other treatment modalities.This article employs the concepts of′righteousness′and′evil′from traditional Chinese medicine,where′righteousness′signifies the′state of a person′and′evil′denotes the′state of a tumor′.We systematically explore collaborative diagnosis and treatment strategies that integrate traditional Chinese and Western medicine for tumor management in the elderly,categorizing the approaches into four conditions:strong righteousness with strong evil,strong righteousness with weak evil,weak righteousness with strong evil,and weak righteousness with weak evil.In cases where both righteousness and evil are strong,the treatment strategy is primarily dominated by Western medicine,with support from traditional Chinese medicine.Conversely,when righteousness is strong and evil is weak,the strategy entails a combination of both Chinese and Western medicine.In situations characterized by weak righteousness and strong evil,the treatment approach is largely guided by traditional Chinese medicine,while also considering equal attention to both modalities.Finally,when both righteousness and evil are weak,the coordinated diagnosis and treatment strategy is primarily based on Chinese medicine,with Western medicine adapting to the circumstances and intervening

关 键 词：肿瘤 中医 中西医结合 

分 类 号：R73[医药卫生—肿瘤]