恶性淋巴瘤发病机制复杂,是临床防治中的难题.本文基于"阳虚痰凝"理论,依据三焦与淋巴组织在位置及生理功能上的相关性,以阳虚导致三焦疏泄失常,凝痰成核为主要病机,提出防治恶性淋巴瘤应重视机体阴阳的动态变化情况,在疾病初起之时以温阳化气行水为主,进展期重视祛瘀排毒消积,后期则主扶阳益阴培本,进而达到恢复三焦正常疏泄功能、化痰消瘤的最终目的,为探求更高效安全的中西医结合治疗方案提供新的思路.

Radiation enteritis is a common intestinal complication arising from abdominal and pelvic malignancies after radiation therapy, which is currently poorly treated by western medicine and greatly affects the quality of life of patients.In this paper, based on the theory of “Zangfu extraordinary connection”,from the perspective of yin and yang properties, generation-inhibition of five elements, and meridian circulation, and in accordance with the western medicine “liver-intestine axis” theory, we clarify the pathological mechanism basis that liver and large intestine are connected with each other in terms of qi and blood, disease transmission and mutual treatment.Moreover, according to the symptoms of radiation enteritis in different periods, we summarized the pathological characteristics of acute radiation enteritis with damp-heat, chronic radiation enteritis with blood deficiency and loss of qi harmony throughout.Therefore, we propose that the treatment should be combined with the patient’s symptoms, the application of liver regulating methods such as clearing heat and dampness, benefiting yin and nourishing blood, regulating qi and relieving depression.If the liver has not been affected, it should be settled first.Since it has been affected, then it should restore its function of lifting and draining, moistening and retaining, thus helping the intestinal bowels to restore its function of purging and excreting, promoting the healing of the disease, in order to supplement and enlighten the subsequent Chinese medicine treatment of radiation enteritis.

乳腺癌相关淋巴水肿(breast cancer related lymphedema,BCRL)是乳腺癌患者最常见的并发症之一,严重影响患者生活质量,可归属于中医"水肿"范畴.《素问·生气通天论篇》认为"因于气,为肿",水肿的发生与人体之气相关.故本文以此立论,结合乳腺癌患者素体肝郁,经手术、放化疗等现代医学治疗后正气受损,阳气不足,肿块虽除,气滞、瘀毒等有形实邪仍残存体内,阻碍阳气布运流行的特点,探讨从气致肿的机理,并以调和阳气为原则,提出益气温阳健脾、理气疏肝、祛邪化瘀以利水等治法,以期更好的指导临床用药.

目的 观察晚期结直肠癌中医干预后的流行病学趋势与相关指标.方法 回顾性分析2000年1月1日-2011年12月31日中国中医科学院广安门医院肿瘤科中医药辅助治疗的213例晚期结直肠癌患者,通过对既往治疗的总结与随访,观察中医药辅助治疗对晚期结直肠癌的疗效与作用,并在既往研究基础上对影响中晚期结直肠癌预后的相关因素进行COX回归分析,筛选出有利因素及不利因素,探索结直肠癌中医病机的发展规律.结果 COX回归分析显示,肝转移为预后不良因素,有肝转移的患者死亡风险为无肝转移患者的1.473倍(HR=1.473).中西医结合组进展风险低于中医组,进展风险为中医组的40.7%.结论 本研究收治的晚期结直肠癌病例基本符合当时国际流行病学变化趋势,脾肾阳虚为最为常见的辨证类型,经COX回归分析,肝转移是总生存期不利的预后因素,中西医结合治疗可降低疾病进展风险.

肺腺癌脉络膜转移在临床上比较少见,对患者的视力产生极大影响且颇具治疗难度.报告中西医结合治疗晚期肺腺癌脉络膜转移病例1例,采用培美曲塞+顺铂方案化疗的同时,治以益气养阴、化痰祛瘀为法,治疗期间据证调方,化疗6个周期视物遮挡感基本消失,视力较前明显改善.

基于"积者阴气,五脏所生",认为五脏阳气失常是肺癌的核心病机.五脏生理之阳虚、病理之阳有余可影响病情发展及治疗的不同阶段.结合现代研究,提出术后气陷、心肺阳虚,化疗伤脾、脾阳不足,久病及肾、肾阳虚衰以及肺癌患者为气郁之体、肝阳不舒等观点.以此探讨患者在不同阶段的病因病机及临床表现,并通过益气升陷、健脾益气、温阳补肾、疏肝理气等法调和五脏阳气进行论治.