<p><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">原发性肺癌简称肺癌，是指发生于支气管粘膜上皮、支气管腺体、肺泡上皮的癌肿。肺组织细胞在一些因素的刺激下癌变，使肺组织异常增生肿大为其病理特点。</span></p><p><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><br/></span></p><p><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">根据古代医籍有关记载，本病属中医“肺积”、“痞癖”、“咳嗽”等范畴。其病因多<span style="color: rgb(161, 35, 1)">从“虚”(气虚及阴、阳虚)、“瘀”(血瘀)、“痰”(痰浊)、“毒”(热毒)四个方面来考虑。</span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)"><br/></span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">其中以肺气阴虚为本，以痰瘀毒邪为标。<span style="color: rgb(161, 35, 1)">本病病位在肺，常累及脾肾。</span>病机是由于肺脾肾虚弱，邪毒的干扰，使肺气闭郁，宣降失司，气机不畅，<span class="">气滞血瘀</span>，肺络受阻，津液输布不利，壅结为痰，瘀痰交阻，日久形成肺积。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><br/></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold">中医治疗本病已取得丰富经验，且经临床和实验观察，疗效也很满意，且毒副作用小，适于长期坚持运用。</span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold"><br/></span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold"><img src="/ueditor/php/upload/image/20250624/1750743303173098.png" title="1750743303173098.png" alt="微信图片_20250418173411.png" width="726" height="408"/></span></span></section><section></section><section><section><section><section><section><section></section></section></section></section><section><section><p style="text-wrap-mode: wrap;margin-top: 0px;margin-bottom: 0px;padding: 0px;box-sizing: border-box"><strong style="box-sizing: border-box;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">【临床验案】</strong></p></section></section></section></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">王某，女，63岁。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">2008年5月发现<span style="font-weight: bold">左肺腺癌，</span>行多周期化疗。2008年10月<span style="font-weight: bold">复查发现双肺内转移，</span>再次行多周期化疗。检查排除脑转移、骨转移及肾上腺转移。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><br/></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="font-weight: bold"> 一诊：</span>2009年8月19日</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="font-weight: bold">症状：</span>咳嗽、咳稀白痰，乏力、气短、胃脘胀满，食欲差，睡眠差，大便偏干燥，小便正常。舌淡暗，舌下脉络迂曲，苔薄白，脉沉细。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><br/></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="font-weight: bold">辨证：</span>肺脾气虚。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="font-weight: bold">治法：</span>补益肺脾。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="font-weight: bold">方药：</span>生黄芪30g、炙黄芪30g、仙鹤草40g、党参20g、<span class="">代赭石</span>30g、白芍40g、芡实30g、桂枝15g、丹参15g、三七块10g、虎杖15g、砂仁<sup style="font-size: 12px">打碎</sup>6g、徐长卿15g、炙杷叶15g、苏荷梗10g、炒枣仁10g、紫苑15g、白花蛇舌草15g、鸡血藤30g、天麦冬<sup style="font-size: 12px">各</sup>15g、淫羊藿30g。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><br/></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold">辨治要点：</span>该患者为老年女性，属肿瘤晚期，经多周期化疗，目前处于稳定。传统医学对于内伤疾病认识，多因正虚邪实，所谓“正气存内，邪不可干”。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)">对于患病者本身机体或多或少存在着阴阳的虚损，从而导致机体不能<span class="">阴平阳密</span>，气机不能条达而导致疾病的发生。</span>从其目前临床表现，乏力、气短，气虚肯定存在，同时因肺气虚损，而出现肺宣发肃降功能失调；因脾气不足，而至脾气运化水谷失调。<span style="color: rgb(161, 35, 1)">因此，在治疗上补益肺脾，同时注重理气活血。</span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)"><br/></span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="font-weight: bold">二诊：</span>2009年9月6日</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="font-weight: bold">症状：</span>患者服用上方10剂，乏力、气短、咳嗽有所好转，纳眠有改善。近日觉头晕沉。二便可。舌脉同前。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="font-weight: bold">辨证：</span>肺脾气虚。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="font-weight: bold">治法：</span>补益肺脾。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="font-weight: bold">方药：</span>生黄芪30g、炙黄芪30g、仙鹤草40g、党参20g、代赭石30g、白芍40g、芡实30g、桂枝15g、丹参15g、三七块10g、虎杖15g、砂仁<sup style="font-size: 12px">打碎</sup>6g、徐长卿15g、炒枣仁10g、鸡血藤30g、淫羊藿30g、桔梗10g、钩藤15g、全蝎6g、生甘草15g。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><br/></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold">辨治要点：</span>患者症状改善较明显，我们辨证用药的思路可继续沿用。<span style="color: rgb(161, 35, 1)">对于其出现头晕沉，考虑与其气血不足，清气不能上承；气血不通，瘀阻脉络均有关系。</span>因此，<span style="color: rgb(161, 35, 1)">在用药上加用通络之钩藤、全蝎。</span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">对于每一个新的患者，最主要的是<span style="color: rgb(161, 35, 1)">把握其主证。</span>当然在对于一个病种的临证经验用药，也给我们提供了很好的方法。<span style="color: rgb(161, 35, 1)">患病的机体肯定存在阴阳的失调，我们用药的目的是用药物的偏性来纠正机体的失调。</span>当然在整体方子中温热药和寒凉药，补药与攻药常常是兼而用之的，纠其原因就在于患病的机体同样是存在寒热错杂，虚实错杂的。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1);font-weight: bold">警示：</span>医案的治疗方案和手法、药物基于专业中医个案辨证，读者谨慎采用，若采用后果自负。</span></section><section><section><section><section><section><section></section></section></section></section><section><section><p style="text-wrap-mode: wrap;margin-top: 0px;margin-bottom: 0px;padding: 0px;box-sizing: border-box"><strong style="box-sizing: border-box;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">【中医辨证用药思路分析】</strong></p></section></section></section></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">肺癌发病是一个复杂的动态变化过程，由于肺脏本身的生理病理特点，决定了肺癌发病过程中证候变化的多样性和病机变化的复杂性。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">结合多年的临床研究，肺癌临床辨证用药思路可概括为以下几点：</span></section><section><section><section><section><section><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;box-sizing: border-box"><strong style="box-sizing: border-box;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">1</strong></p></section></section></section><section><section><section></section></section></section><section><section><section><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;box-sizing: border-box"><strong style="box-sizing: border-box;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(0, 0, 0)">紧扣主体特征，确定治疗用药。</span></strong></p></section></section></section></section></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">临床研究显示：<span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold">气阴两虚 ，毒瘀互结是肺癌发病过程中的主体特征，</span>因此，<span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold">益气养阴、化瘀解毒是肺癌临床治疗的基本方法。</span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">围绕这一特征和治法，<span style="color: rgb(161, 35, 1)">临床常以沙参麦门冬汤为基础方加减。</span>选用沙参、天门冬、麦冬、五味子、黄芪、女贞子、冬虫夏草、天花粉、丹参、莪术、鱼腥草、白花蛇舌草等。</span></section><section><section><section><section><section><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;box-sizing: border-box"><span style="font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">2</span></p></section></section></section><section><section><section></section></section></section><section><section><section><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;box-sizing: border-box"><strong style="box-sizing: border-box;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="font-size: 17px"><span style="color: rgb(0, 0, 0)">辨析动态特征，随证灵活加减。</span></span></strong></p></section></section></section></section></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold">临床辨治肺癌难点在于，肺癌发病过程中证候变化的多样性和病机变化的复杂性。</span>所以，全面辨析动态特征，随证灵活加减，对肺癌临床治疗至关重要。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)">如兼痰凝湿阻者，</span>可加贝母、半夏、僵蚕、生薏苡仁、瓜蒌、夏枯草等；<span style="color: rgb(161, 35, 1)">热毒蕴肺者，</span>除用鱼腥草、白花蛇舌草外，还可加蚤休、龙葵、山豆根等；<span style="color: rgb(161, 35, 1)">饮停胸中者，</span>加葶苈子、泽泻、猪茯苓、蝼蛄等；<span style="color: rgb(161, 35, 1)">气血两亏者，</span>加鸡血藤、补骨脂、当归、生首乌、自然铜等；<span style="color: rgb(161, 35, 1)">腑气不通者，</span>加大黄、生白术、生首乌、肉苁蓉、火麻仁等，注意通腑泻下时，避免使用峻下之药，应以润下为主；<span style="color: rgb(161, 35, 1)">瘀滞明显者，</span>加重活血化瘀的力度，可加用守宫、全蝎等虫类药物。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><br/></span></section><section><section><section><section><section><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;box-sizing: border-box"><strong style="box-sizing: border-box;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">3.</strong><strong style="box-sizing: border-box; font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;"><span style="font-size: 17px">注重辨证与辨病结合。</span></strong></p></section></section></section></section></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">不同分期、不同病理性质的肺癌临床表现、治疗方法、转变规律等均有所区别，<span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold">明确不同肺癌特点，针对性地使用中药，可收到事半功倍的效果。</span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">如<span style="color: rgb(161, 35, 1)">肺癌早期</span><span style="color: rgb(161, 35, 1)">由于邪毒未深，正气未伤，</span><span style="color: rgb(161, 35, 1)">治疗以祛邪为主，佐以扶正，配合手术、放疗、化疗；</span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)">中晚期肺癌</span>多由于久病正气过伤，或术后体液丢失过多，或放、化疗不良反应过重，或因有转移引起胸、腹水或其他并发症，致机体进一步消耗。<span style="color: rgb(161, 35, 1)">因中晚期肺癌虚损情况突出，以正虚、阴伤为主，</span><span style="color: rgb(161, 35, 1)">治宜扶正为主，采用益气养阴、解毒散结、清化痰热等法。</span></span></section><section><section><section><section><section><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;box-sizing: border-box"><strong style="box-sizing: border-box;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">4.</strong><strong style="box-sizing: border-box; font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;">合理使用有毒药物。</strong></p></section></section></section></section></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)">在使用攻毒药同时，应照顾正气，</span>合理配伍且注意药物的合理炮炙，<span style="color: rgb(161, 35, 1)">选择适宜剂型，</span><span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold">这样即可以发挥其治癌作用，又可以减少其不良反应。</span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">肺癌临床常用有毒药物，如干蟾皮（一般用量为8g）、生半夏（一般用量为7g，先煎）、守宫、硇砂、露蜂房等。</span></section><section><section><section><section><section><p style="margin-top: 0px;margin-bottom: 0px;padding: 0px;box-sizing: border-box"><span style="font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">5</span><strong style="box-sizing: border-box; font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, "Helvetica Neue", "PingFang SC", "Hiragino Sans GB", "Microsoft YaHei UI", "Microsoft YaHei", Arial, sans-serif;"><span style="font-size: 17px">巧妙配伍温化药物。</span></strong></p></section></section></section></section></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">临床中，肺癌晚期患者往往由于气阴两伤日久，出现阴伤及阳的现象。因此，<span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold">在采用养阴药的同时，常加入温阳补肾的药物，</span>如补骨脂、淫阳藿等。<span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold">一方面可防止阴伤及阳现象发生，另一方面又可调和诸药，避免养阴助湿。同时，温药有助化解痰湿，促进水液代谢的正常运行。</span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">根据肺癌临床辨证思路，结合中晚期肺癌的临床特点，认为此期患者病机多表现为<span style="color: rgb(161, 35, 1)">气阴两虚、瘀毒内结，治疗上应益气养阴、化瘀解毒，组成了益气养阴汤。</span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">具体药物如下：沙渗15g、麦冬15g、五味子15g、鱼腥草30g、白花蛇舌草30g、生黄芪30g、猪茯苓各15g、地龙30g、川贝8g、莪术30g、炙枇杷叶15g、女贞子30g、干蟾皮8g。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)">配合放疗，</span>加紫草、丹皮、生地黄等；</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)">配合化疗，</span>加当归、生首乌、鸡血藤、白芍、阿胶等；</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)">淋巴结转移者，</span>加夏枯草、山慈姑、<span class="">全虫</span>等；</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)">胸膜转移有胸水者，</span>加葶苈子、泽泻、大戟（一般用量为3g，不用粉）、龙葵等；</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)">肝转移者，</span>加白芍、青蒿、鳖甲、仙鹤草、秦艽等；</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)">骨转移者，</span>加补骨脂、自然铜、威灵仙等；</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)">脑转移者，</span>加全虫、蜈蚣、天麻等；咳嗽、痰多黏稠者加半夏、<span class="">全瓜蒌</span>、枇吧叶、贝母等；</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)">大便干燥者，</span>加火麻仁、酒大黄、生白术等；</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)">发热者，</span>加丹皮、紫草、黄芩、银柴胡等。</span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold">临床应用此法治疗中晚期肺癌取得了很好的疗效，较大的减轻了化疗的毒副反应，改善了患者的生活质量，延长了生存期。</span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold"><br/></span></span></section><section><span style="font-size: 17px;font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif">通过203例晚期非小细胞肺癌患病例研究发现：</span></section><section><span style="font-size: 17px;font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold">患者中以气阴两虚及痰瘀互阻证型最为常见，</span>分别占35.43%，其他依次为脾虚痰湿（11.81%），肺脾气虚（11.81%），气虚血瘀（8.66%），痰湿阻滞（6.30%）等，各证型可相兼出现。</span></section><section><span style="font-size: 17px;font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="background-color: rgb(149, 8, 0);color: rgb(255, 255, 255);font-weight: bold">中医用药方面，以益气养阴（59.84％）、健脾利湿（27.56％）、理气化痰（20.47％）、活血化瘀（18.11％）最为常用。</span></span></section><section><span style="font-size: 17px;font-family: 'mp-quote', -apple-system-font, BlinkMacSystemFont, 'Helvetica Neue', 'PingFang SC', 'Hiragino Sans GB', 'Microsoft YaHei UI', 'Microsoft YaHei', Arial, sans-serif"><span style="color: rgb(161, 35, 1)">研究同时表明：中西医结合治疗较单纯西医治疗可获得较高的肿瘤控制率；</span>显著提高患者的生活质量；延长生存期和疾病进展时间；具有较好的费用效果比；<span style="color: rgb(161, 35, 1)">可有效降低肿瘤放、化疗不良反应，提高临床疗效。</span></span></section></p><p><br/></p>
2025-06-24 13:37:49
