目的:研究肺癌中医证候与植物神经及免疫功能状态的相关性。方法:对62例肺癌患者评估植物神经平衡指数,及检测外周血T淋巴细胞亚群。结果:肺郁痰瘀型倾向于交感神经功能正常、增强或亢进,脾虚痰湿型倾向于副交感神经增强或亢进。肺癌各中医证型免疫功能指标水平对比,差别无统计学意义(P>0.05);免疫功能各指标的降低或升高,肺癌的4种证型对比,差别无统计学意义(P>0.05)。结论:植物神经功能状态可较准确反应肺癌的寒热虚实状态,而免疫功能则与肺癌虚实关系不大。

晚期肺癌气血阴阳俱虚,形体枯瘦,咳吐白痰,辨治当属于"肺痿"范畴。炙甘草汤为治疗肺痿方药之一,主治血脉枯竭,适于晚期肺癌恶病质,体质羸瘦虚弱,见咳而涎唾多,或烦闷欲吐,心动悸者,舌光无苔,脉细数或结代。

The invention relates to a Chinese herbal medicine pill for treating barrenness and gynecologic miscellaneous diseases, which is prepared from 29 Chinese herbal medicine materials of nutgrass flatsedge, giant mistletoe, radix salviae miltiorrhizae, tuber fleeceflower, donkey-hide gelatin, prepared rehmannia root, sophora fruit, angelica, spina date seed, white peony root, cuttlebone, scaly anteater, Chinese dodder, motherwort, herba lycopi, ginseng, astragalus root, poria from Yunnan of China, white atractylodes rhizome, radix dipsaci from Sichuan of China, radix achyranthis bidentatae, shelled cedar seed, eucommia bark, ricepaper plant pith, rhizoma ligustici wallichii, radix bupleuri, rhizoma sparganii, peppermint leaf and TurmericRoot-tuber. The Chinese herbal medicine pill is suitable for the integrative treatment of female posterior sterility and various gynecologic miscellaneous diseases, commences the integrative functions of comprehensively conditioning qi and blood, invigorating the five internal organs, eliminating the pathogenic factor and reinforcing body resistance, has the advantages of precise and appropriate matching, extensive treatment range of disease varieties, obvious curative effect, short treatment period, low treatment cost and the like and treats both the principal and secondary aspects of diseases.

<正>肺癌是常见多发肿瘤,咳喘是肺癌病程中的常见症状,多与肿瘤或感染有关。因于肿瘤而起者,化疗或可奏效,但常有体质不能耐受化疗者;因于感染者,抗感染治疗或少效或不效,临床所见甚多。医者每拘

柴胡桂枝干姜汤见于<伤寒论>第147条:"伤寒五六日,已发汗而复下之,胸胁满微结,小便不利,渴而不呕,但头汗出,往来寒热,心烦者,此为未解也,柴胡桂枝干姜汤主之."<金匮要略>附柴胡桂姜汤:"治疟寒多微有热,或但寒不热."另外,胡希恕[1]认为第148条中的阳微,指津液微少,由于津液内竭而致大便硬结,与第147条一样,都是由于津液伤甚而呈现半表半里阴证,故治疗皆应用柴胡桂枝干姜汤.其说言之有理.本方以柴胡除往来寒热及胸胁满,栝蒌根生津止渴,黄芩除心烦,桂枝、甘草降气冲,甘草、干姜理中气以复津液,牡蛎协柴、芩治心下微结,协栝蒌根止渴,协桂枝而止汗.本文试结合诸家论述探讨本方方证及其在肿瘤临床的应用.

In spite of great achievements in treatment of tumors by Chinese medicine,many problems arise regarding categorization of patterns,normalization of medication,improvement and evaluation of effect,challenges raised by evidence-based medicine,etc.In addressing these problems and opening up new dimensions,it is necessary to establish normalized clinical treatment by drawing upon Shang Han Za Bing Lun(Treatise on Cold Damage and Miscellaneous Diseases)and classical formulas,for all diseases fall into the category of six-meridian syndrome,and classic formulas are normalized in medication,stable in effectiveness,easily accessible for research.

Objective To investigate the therapeutic effect of Shen Qi Guben Recipe(SQGP)for Lewis lung cancer(LLC)mice with spleen-deficiency and to explore its therapeutic mechanism.Methods Seventy-two mice were equally randomized into four groups: LLC mice(group A),LLC mice with spleen deficiency treated by saline(group B),LLC mice with spleen deficiency treated by intraperitoneal injection of cisplatin 1mg/kg(group C)and LLC mice with spleen deficiency treated by SQGP(group D).Firstly,mice models of spleen-deficiency were established by intragastric administration of rhubarb decoction for seven days.Then the mice were inoculated subcutaneously with 0.2mL(5×106/mL)tumor cell suspension of subculture LLC from mice right axilla.On the second day after inoculation,the mice were given intragastric administration of corresponding medicine for 10 days according to the experimental design.After treatment,the weight of tumor mass,body weight with tumor removed,and the weight of spleen and thymus gland were examined.Meanwhile,the serum levels of tumor necrosis factor α(TNF-α),and interleukin 6(IL-6)were detected by radioimmunoassay.Results The tumor mass weight in group B was the highest in the four groups,and there were statistical significance(P0.05 or P0.01).The body weight with tumor removed was higher in group D than that in other groups(P0.05).The weight of thymus gland in groups B and C was more lower than that in group A(P0.01).Serum TNF-α level was increased in groups C and D(P0.05 or P0.01)and serum IL-6 levels was decreased(P0.01)in group D.Conclusion The anti-tumor mechanism of SQGP is probably related with the increase of serum TNF-α level,decrease of IL-6 level and the improvement of immune function.

小柴胡汤为和法代表方,具有和解少阳、疏肝利胆、宣畅三焦、健脾和胃、通津液、降相火等功效,切合肝癌肝郁脾虚、肝火内盛的病机,可用于肝癌的预防与治疗,对肝癌常见症状如黄疸、血证、腹水、发热及栓塞后综合征等亦有较好的疗效,与其他诸法合用更可拓展其在肝癌中的应用。

目的:通过对既往临床研究资料的回顾性分析,探讨中晚期非小细胞肺癌(NSCLC)脾虚证患者的顸后情况.方法:共收集NSCLC 276例,按临床治疗方案分为中医组99例、中西医组103例、西医组74例,并根据中医辨证又分为非脾虚组67例,脾虚组209例(其中Ⅰ度脾虚90例,Ⅱ度以上脾虚119例).中医组采用辨病与辨证相结合的治疗方法,按肺郁痰瘀、脾虚痰湿、阴虚痰热、气阴两虚等证型给予相应汤剂治疗,并服用鹤蟾片加参一胶囊;西医组采用含铂化疗方案;中西医组采用上述2种治疗方法相结合.以平均生存期及中位生存期为主要终点指标,并综合评价影响生存期的预后因素.结果:平均生存期及中位生存期脾虚组分别为(368±19)天、(270 ±16)天,非脾虚组分别为(465±31)天、(515±107)天,2组比较,差异均有非常显著性意义(P＜0.01).平均生存期及中位生存期Ⅰ度脾虚分别为(394 4±28)天、(299±69)天,Ⅱ度以上脾虚分别为(332 4±23)天、(265±11)天,2组比较,差异无显著性意义(P＞0.05).COX比例风险回归模型分析差异有显著性意义的预后因素为:行为状态评分(PS)、乳酸脱氢酶(LDH)、血红蛋白(Hb)、I度以上脾虚(PIXU1)、性别(SEX)、中医证型(CHTYPE).根据回归系数B＞0,PS、LDH、Hb、PIXU1、SEX、CHTYPE为预后危险因子,表明级别越高,预后越差.结论:脾虚在中晚期肺癌中占有相当的比重,随着脾虚程度的加重,患者的生存期趋向缩短,提示脾虚程度与患者生存时间有一定关系,而且是影响中晚期肺癌的预后因素之一.

Spleen asthenia are common syndrome at the advanced stage of lung cancer,there are important influences in the prognosis of lung cancer.The method strengthening earth to generate metal contains invigorating spleen based on splenic yang and tonfying spleen based on splenic yin,this method,as the key method,can improve life quality,prolong life span,can be used as long term therapy method at advanced stage of tumor.

桂枝汤及其类方如小建中汤、黄芪建中汤等具有疏肝健脾、活血消、补虚退黄、消肿除胀之功,与肝癌肝郁脾虚、瘀血结聚的基本病机相符合,对肝癌及其并发症如黄疸、腹水、肿胀等具有较好的疗效,在肝癌的治疗中具有一定的价值。

Objective: To evaluate the concordance between the single diameter and the double diameter in response rate of the non-small cell lung cancer. Methods: The tumor response rate of 187 patients with lung cancer was evaluated by RECIST and WHO criteria respectively. The largest diameter and perpendicular diameter of tumor were measured and the curative effect was calculated by the sum of the largest diameters (LDs) and the product of multiplication of the largest perpendicular diameters (LPDs) respectively. According to the percentage of tumor shrinkage, response rate was divied into the CR, PR, SD and PD groups. Results: The concordance between the methods was good, and the coefficient correlation of the response rate rs=0.622, and coefficient correlation of stabilization rate rs=0.864, which showed that there was a correlativity between the two methods (P<0.05). Conclusion: RESCIT is more simple and easy than WHO criteria, and there is a good concordance between the two appraisement methods.

[Purpose]To evaluate the efficacy TCM OES in advanced non-sm all cell lung cancer.[M ethods]One hundred and ninety-one advanced non-sm all cell lung cancer patients were en-rolled in the clinicaltrial(TCM group, 99 patients; western m edicine group, 92 patients). Theoverallresponse ofTCM OES included change oftum orsize (30% ),sym ptom s (15% ),perform ancestatus(15% ),survivaltim e (40% ).The score of75 to 100 is difinited as obvious efficacy,50 to 70,effective;25 to 49,stable disease and less 25,ineffective.Both groups were evaluated with TC-M OES and Response Evaluation Criteria in Solid Tum or(RESCIT). [Results]According to RE-CIST,CR +PR +SD in TCM group was 66.7% ,and western m edicine group, 76.1% , the latter ishigherthan the form er(P=0.151).According to TCM OES,overallresponse rate in TCM group was66.7% ,and western m edicine group,56.5% ,the form eris higherthan the latter(P=0.149).Cor-relative analysis showed thatboth evaluation system were close correlation (P0.01).[Conclu-sion]The TCM OES can reflectthe efficacy ofTCM in treatm entfortum or.Itis superiorto evalu-ation with response rate only.

中医药在中晚期肝癌和肝癌术后、介入后的治疗中占有重要地位.著名中医肿瘤学家周岱翰教授,临床推崇清代王旭高的治肝三十法,笔者有幸跟随导师学习,现将老师治疗肝癌经验介绍如下.

《医学噎膈集成》为清代光绪年间吴静峰(仓山)所撰，是古医籍中关于噎膈的唯一专著。书中辑有医论三篇，方剂八十二则。现将其学术思想简介如下。 1 病机强调肝郁津亏气逆……