恶性肿瘤相关性胃瘫是影响恶性肿瘤患者生活质量的重要因素,是手术和放疗后的常见并发症之一.西医对于本病的治疗方式有限且效果不理想,因此探索针对本病的中医治疗策略具有重要的临床意义.曹阳教授认为本病以脾阳胃阴虚弱,复受手术、放疗影响至体内寒热偏盛为基本病机,兼有气滞、痰湿,当从寒热辨证施治.用药时随证选取温中药或清热药,兼顾行气化湿.确立了在患者禁食期以中药膏摩为主要治疗方式,同时酌情配合其他外治治疗,恢复经口进食后加用中药浓煎剂内服的综合治疗方案,在临床应用中取得了良好的治疗效果,为中医药治疗恶性肿瘤相关性胃瘫拓宽了思路.文末并附验案一则,以证其效.

"肿瘤绿色治疗"模式是一种肿瘤防治新体系,该体系以"现代微创技术+中医药调理"为主要治疗手段,强调对肿瘤的控制而非根治.在"肿瘤绿色治疗"模式中,肿瘤被认为是一种"有生命"的邪气,寒热是阴阳范围内的有形之物,在肿瘤形成早期,肿块局部由寒痰血瘀等邪实构成,其"体阴而用阳"的特性致使患者整体日渐多虚多寒.根据邪正盛衰的变化特点,"肿瘤绿色治疗"模式将肿瘤发展分为急性期、慢性期和隐匿期,并针对性确定了"霸道""王道""帝道"3 种治疗方法.从寒热角度来讲,深部热疗属热性,根据"寒者热之"的原则,深部热疗可在慢性期和隐匿期发挥温阳散寒的作用.在慢性期,深部热疗发挥扶正和祛邪的双重作用,重在调理慢性期患者全身不适症状.在隐匿期,"帝道"重在协调阴阳,改善患癌体质.治疗前,综合评估患者体质及证候类型是否适合深部热疗,根据患者身体状况及对热的耐受程度制定个性化治疗方案."肿瘤绿色治疗"模式将不断探索基于中医属性指导下深部热疗的临床应用,并联合其他治疗方法服务于临床.

乳腺癌是女性最常见的恶性肿瘤之一,在西医治疗的基础上配合中医治疗能极大改善乳腺癌患者的预后.阴阳虚损是乳腺癌的基本病机,可从阳虚证、阴虚证论治乳腺癌.乳腺癌以阳虚为主者,易感风寒湿等外邪,阳虚失于温煦、推动,日久酿成痰湿血瘀,表现为病变局部早期肿势弥漫、皮色不变、不痛不痒及全身阳虚的证候特点,证似阴疽,治以阳和汤.乳腺癌以阴虚为主者,邪入肝络为病,伏于营血,日久化热,表现为病变局部更易溃烂、转移、向晚期进展及全身阴虚的证候特点,证似邪伏阴分,治以青蒿鳖甲汤.在阴中求阳、阳中求阴的理论指导下,结合整体正虚、局部邪实的疾病特点,可阳和汤和青蒿鳖甲汤联合应用,并配合外治.

恶性肿瘤是临床常见的疾病,近些年受到多种因素影响,发病率呈现增长趋势,晚期恶性肿瘤不仅会导致患者的生命质量降低,影响患者的身体健康,导致患者死亡.随着医疗卫生事业的快速发展,中医治疗也更多的应用于恶性肿瘤的治疗.现将从现代医学的发展、中医治疗肿瘤的基础理论、中医治疗恶性肿瘤的策略等方面通过循证医学的方法,系统的阐述中医理论在治疗中晚期肿瘤的策略,分析中医在多种肿瘤中发挥的提高患者高生存率、延长生存时间、提高生命质量、改善不良症状中的功效,为中医治疗中晚期肿瘤的策略及理论研究提供理论基础.

乳腺癌相关淋巴水肿发病率高,临床治疗手段有限,疗效不佳且难以治愈,目前已成为困扰患者及医护人员的又一大难题.曹阳教授在治疗乳腺癌相关淋巴水肿方面具有独特的治疗经验,临床效果显著,认为其发生的病机多为阳虚水犯,治疗上宜采用温阳利水法.本文通过总结古代文献及曹阳教授临床经验,为温阳利水治疗乳腺癌相关淋巴水肿提供理论支持和有效方法.

卵巢癌是女性生殖器官常见肿瘤之一,发病率逐年上升.将卵巢癌与中医所述癥瘕类比,从古籍文献描述、病因病机等方面进行探原,发现卵巢癌与血瘀证的形成密切相关,通过进一步探究,发现血瘀的形成与阳气亏虚密切相关,并总结古今医家在卵巢癌的治疗中应用温阳活血法的组方特点.

"肝脾相关"理论是以五行学说为基础,结合脏腑功能而形成的一个重要的中医理论.本文通过对"肝脾相关"学术理论渊源及内涵进行分析,进一步阐释肝脾两脏在生理病理方面的相互影响,同时结合现代临床医家对该理论的应用及自身临证体会,探讨"肝脾相关"理论与乳腺癌病因病机之间的联系及这一理论在乳腺癌治疗中的具体应用.基于"肝脾相关"理论治疗乳腺癌的主要作用体现在疏肝解郁和健脾益气两方面,疏肝解郁以散邪、健脾益气以扶正,两者相辅相成,达到祛邪不伤正,扶正不留邪的目的,这也为乳腺癌的临床治疗提供了一个新的辨证施治思路.

目的 观察温阳益气方对乳腺癌术后患者生活质量的影响和中医症状改善的临床疗效.方法 将60例乳腺癌术后阳气虚证患者随机分为治疗组30例、对照组30例,剔除脱落病例后治疗组28例、对照组29例.在口服第三代芳香化酶抑制剂的基础上,治疗组口服温阳益气方,对照组口服安慰剂.观察2组健康调查简表(SF-36)评分、乳腺癌患者生命质量测定量表(FACT-B)评分、中医证候疗效、中医症状评分.结果 2组SF-36量表评分比较,治疗后治疗组一般健康状况、生理机能、躯体疼痛、精力、社会功能、心理健康评分较本组治疗前均提高(P<0.05).对照组躯体疼痛、精力评分较本组治疗前均提高(P<0.05),治疗组一般健康状况、生理机能、精力、社会功能评分较对照组提高明显,治疗前后评分差值比较,差异均有统计学意义(P<0.05).2组FACT-B量表评分比较,治疗后治疗组社会/家庭、功能状况、生理状况、个人情感、附加关注评分较本组治疗前均提高(P<0.05).对照组附加关注评分较本组治疗前提高(P<0.05).治疗组社会/家庭、功能状况、生理状况、个人情感评分较对照组提高明显,治疗前后评分差值比较,差异均有统计学意义(P<0.05).2组中医证候疗效比较,治疗后治疗组28例中,显效9例,有效13例,无效6例,总有效22例,总有效率为78.57％;对照组29例中,显效0例,有效19例,无效10例,总有效19例,总有效率为65.52％.经秩和检验,Z=-4.895,P<0.001,说明治疗组中医证候疗效优于对照组.2组中医症状评分比较,治疗后治疗组神疲乏力、多汗、小便清长、大便溏薄、失眠评分较本组治疗前均减少(P<0.05),对照组大便溏薄评分较本组治疗前减少(P<0.05).治疗组神疲乏力、多汗、小便清长、大便溏薄、失眠评分较对照组减少明显,治疗前后评分差值比较,差异均有统计学意义(P<0.05).结论 温阳益气方能提高乳腺癌术后患者生活质量,改善乳腺癌术后阳气虚的相关症状,具有较好的临床疗效.

目的:癌性发热作为肿瘤患者临床常见症状,其在病因病机、 发病形式及临床表现上均符合伏邪致病的特点,与伏邪之间存在密切的联系.基于伏邪理论分析癌性发热的病机,多为气、 血、 阴、 阳之正气亏虚,伏邪产生,导致痰湿瘀血,形成积聚,日久化热,从伏邪辨治癌性发热临床治疗须以扶助正气为根本,采用温阳化积、 滋阴化积、 益气化积、 养血化积、 活血消积、 祛湿化积等治疗方法清除伏邪,使正复邪去,积消热平.

Breast cancer is the most common malignancy of women,which Chinese medicine has irreplaceable advantages in the comprehensive treatment.According to the ancient literature record,breast cancer belongs to yin syndrome,usually caused by yang deficiency lead to cold phlegm aggregated to form.Phlegm related to the incidence of cancer closely.Warming yang reinforcing qi with reducing phlegm and resolving masses method can be used in the treatment.By this brief discussion about ancient literature and clinical experience,to provide a theoretical basis of the treatment and dialectical thinking of breast cancer by clinical application warming yang reducing phlegm and resolving masses method.

Objective:To study the effect on the growth of transplanted tumor and lung metastasis in a green fluorescent protein marking human triple-negative breast cancer MDA-MB-231-GFP nude mice model when treated with the dichloromethane extract of fresh Tubeimu (Rhizoma Bolbostemmae) (DEFT).Methods:The nude mice model was established by surgical orthotopic transplantation method.The mice were randomly divided into 3 groups (5 mice in each group):negative control group (0.9％ sodium chloride),low dose group (DEFT,50 mg/kg) and high dose group (DEFT,75 mg/kg).Each group was treated with oral administration once a day for 58 days.The tumor image was collected by the fluorescence imaging system twice each week,and the software was used to calculate the tumor area.At the end of the treatment,the tumor weight was recorded and the lung metastasis was observed by the fluorescence imaging system.Results:Weight changes between the control group and the treatment groups were not significantly different before and after.The tumor area between three groups began to grow significantly differently after 14 days (P＜0.05).Lung metastasis rates decreased significantly at the end of the experiment (P＜0.05).The treatment groups showed less tumor weight than the control group,but there was no significant difference (P＞0.05).Conclusion:The dichloromethane extract of fresh Tubeimu (Rhizoma Bolbostemmae) had some inhibitory effect on the growth of malignant tunors and the occurrence of lung metastasis in human triple-negative breast cancer MDA-MB-231-GFP nude mice model.

Objective To investigate the effect of Wenyang Huatan Sanjie Formula on the inhibition of breast cancer.Methods 30 nude mice were randomly divided into 5 groups (n =6):model group, tamoxifen group,middle dose group of Wenyang Huatan Sanjie Formula,high dose group of Wenyang Huatan Sanjie Formula and combination group (tamoxifen + middle dose of Chinese medicine).After the estrogen receptor(ER)breast cancer nude mice transplantation tumor model was set up,the model group was given distilled water,tamosifen group was given tamoxifen citrate solution,middle and high dose groups of Wenyang Huatan Sanjie Formula were treated with middle and high dose of the formula, and the combination group was given both tamoxifen citrate solution and middle dose of Wenyang Huatan Sanjie Formula.Continuous medication lasted 15 days and general status,body weight,food intake, tumor weight and tumor inhibitory rate of nude mice were recorded.Results The mental state of nude&nbsp;mice in every group was weak before giving drugs.After taking drugs,the mental state of tamoxifen group and middle and high dose groups of Wenyang Huatan Sanjie Formula was improved.Body weight of mid-dle and high dose groups of Wenyang Huatan Sanjie Formula increased significantly (P <0.05).Food taking of middle dose group of Wenyang Huatan Sanjie Formula was significantly higher than model group and combination group (P <0.05).Tumor weight of tamoxifen group and high dose group of Wenyang Huatan Sanjie Formula were significantly lower than model group(P <0.05 ).Compared with middle dose group of Wenyang Huatan Sanjie Formula,tumor weight of tamoxifen group was decreased signifi-cantly (P <0.05).Tumor inhibitory rate of tamoxifen group,middle and high dose groups of Wenyang Huatan Sanjie Formula,combination group were 47.89%,14.03%,43.07%,25.00%,separately. Conclusion Wenyang Huatan Sanjie Formula could improve the general status and body weight,restrain the growth of breast cancer transplantation tumor in nude mouse,which has a certain correlation with drug dosage.

目的:研究二陈汤对非小细胞肺癌(NSCLC)痰证患者生活质量的影响.方法:采用前瞻性临床研究方法,收集东方医院肿瘤科门诊与住院晚期NSCLC痰证患者40例给予二陈汤口服2周,对治疗前后生活质量进行比较.结果:QLQ-C30和QLQ-LCl3量表评分显示,治疗后的整体评分高于治疗前,治疗前的躯体功能、角色功能、消化道症状、呼吸道症状、其他症状评分高于治疗后,认知功能评分高于治疗后.结论:二陈汤可显著提高NSCLC痰证患者的生活质量.

Objective To explore the clinical effects of Xiaoaiping Injection combined with cisplatin in the treatment of bladder cancer.Methods Patients (100 cases) with bladder cancer of Dongfang Hospital of Beijing University of Chinese Medicine from May 2011 to December 2014 were randomly divided into control and treatment groups, and each group had 50 cases. The patients in the control group were iv administered with Cisplatin for injection 6 mg added in 40 mL normal saline, three times per week, and 3 weeks undergoing therapy as one treatment period. The patients in the treatment group were iv administered with Xiaoaiping Injecton on the basis of control group, 2 tubes/time, once daily. One course of treatment was three weeks, and two groups were treated for three courses. After treatment, the efficacy was evaluated, and recent quality of life and drug adverse reactions of two groups were observed.Results After treatment, the total effective rate of treatment groups was 90.0%, which was higher than that (72.0%) of control group, and there were differences between two groups (P< 0.05). The scores of self perceived symptoms, daily life, social activities, psychological and emotional state, physical and physiological function, and total score in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P < 0.05). The incidences of adversereaction such as white blood cells and platelets reduced, nausea and vomiting, alopecia, anemia, and skin rash were significantly lower than those in the control group, and the difference was statistically significant in the same group (P < 0.05).Conclusion Xiaoaiping Injection combined with Cisplatin for injection in treatment of bladder cancer has higher efficiency, can significantly improve the quality of life of patients, less drug adverse reactions, satisfactory results, which has a certain clinical application value.

目的 观察温通消肿外敷方患臂温敷治疗乳腺癌术后上肢水肿的临床疗效.方法 将符合入组标准的96例乳腺癌术后上肢水肿患者随机分为试验组和对照组,每组48例.试验组予温通消肿外敷方患臂温敷,对照组予安慰剂患臂温敷.观察2组患者治疗前、治疗后14 d上肢臂围和患肢症状评分,最终评价临床总有效率.结果 试验组总有效率为51.3％,对照组为68.9％,2组比较无统计学意义(P＞0.05).结论 "温法"外敷治疗局部辨证为寒证的乳腺癌术后上肢水肿具有一定疗效.

Objective:To establish a green fluorescent protein marking human breast cancer MDA-MB-231-GFP model,evaluate anti-cancer effect of Tubeimu extract on MDA-MB-231-GFP nude mice model.Methods:Using orthotopic transplantation method,build green fluorescent protein markers in human breast cancer MDA-MB-231-GFP model.Through the comparison of the negative control group(oral administration of saline),positive control group(intraperitoneal administration of Paclitaxel,20mg/kg),low dose group(oral administration of Tubeimu extract,10mg/kg) and high dose group(oral administration of Tubeimu extract,50mg/kg) of the tumor inhibition rate,evaluate the effects on tumor growth.Results:Weight changes between bland group and the treatment group were not statistically significant difference before and after.The experimental results show that,tumor size and weight change were not statistically significant differences between the low dose group and bland control group;but tumor size in the high dose group and positive control group decreased significantly(P0.05,P0.01).Conclusion:Oral administration of higher doses of Tubeimu extract had anticancer effect on MDA-MB-231-GFP nude mice model.

目的 对女性乳腺癌患者回顾性调查研究,揭示乳腺癌阳虚证型的广泛性及其脏腑分型特点,为乳腺癌个体化预防、治疗提供新思路.方法 对118例女性乳腺癌患者辨证分型,并对阳虚证型进行脏腑辨证聚类,探讨治疗对阳虚证型的影响.结果 阳虚证型在乳腺癌患者中占明显优势(治疗前78例,治疗后64例,与其它证型比较均P＜0.01);阳虚证型中脾阳虚多见,其次为脾肾阳虚(治疗前后脾阳虚证型34例和23例,脾肾阳虚证型21例和16例,与其它证型比较均P＜0.01).中医中药对各阳虚证型影响较大(中药参与组阳虚证型改善率为82.69%,P＜0.01).结论 阳虚是乳腺癌患者的主要病因病机之一,且阳虚体质的改善与否可能影响到乳腺癌发病、术后或治疗后的复发、转移及生存期.所以女性乳腺癌患者的个体化预防和治疗中应注意"补阳"治疗.

Objective To study the effect of Erchen Decoction(ECD) on the expression of ICAM-1 and p38 protein in pulmonary carcinoma cell line A549.Methods A549 cells were divided into five groups:blank group,ECD control group,group induced by TNF-α,ECD treated group,p38 inhibitor-SB203580 group.A549 cells were treated by TNF-α to induce high expression of ICAM-1 and p38 protein,and then treated with ECD drug-containing serum and p38 inhibitor-SB203580.The expression of ICAM-1 was determined with RT-PCR,the expression of p38 protein was determined with western blotting.Results After treated by TNF-α,expression of ICAM-1 and p38 protein of A549 cells were highly induced compared with blank group(P0.01).After treated by ECD and SB203580,expressions of ICAM-1 and p38 protein of A549 cells were obviously reduced(P0.01),compared with group induced by TNF-α.Conclusion ECD can regulate the expression of ICAM-1 by inhibiting the activity of p38 protein in A549 cells,this may be one of the mechanism that ECD plays a role in anti-metastasis of lung.

对129例乳腺癌患者的中医证候特点、手术前后中医证候变化规律进行探讨,并分析乳腺癌临床分期、病理特征与中医证候的相关性.结论:阳气虚是乳腺癌的基本病机之一,手术可以有效祛邪同时损伤阳气；阳气虚患者中Her-2阳性表达率较高,益气温阳法也许可以有效控制难治性乳腺癌.

Objective To observe the value of whole body 18F-FDG PET/CT in cryocare targeted cryoablation therapy.Methods Totolly 100 cancer patients were examined with CT and whole body PET/CT before therapy.Results According to PET/CT and CT,lung tumors were detected in 53 patients,liver neoplasms were found in 22 patients,while pelvic masses were shown in 11 patients.Clinical stage were changed in 23 cases,while the treatment plan were changed in 17 cases,including 12 cases of lung tumors(12/53,22.64%),3 casesof liver neoplasms(3/22,13.64%) and 2 cases of pelvic masses(2/11,18.18%).Conclusion Whole body PET/CT can provide effective information for the treatment strategy of cryocare targeted cryoablation therapy.