[1]蔡丽珍,白瑞娜,张 路,等.基于“痰夹瘀血”理论探讨乳腺癌相关淋巴水肿因机治疗[J].陕西中医,2023,(10):1420-1423.[doi:DOI:10.3969/j.issn.1000-7369.2023.10.019]
　CAI Lizhen,BAI Ruina,ZHANG Lu,et al.Based on the theory of “phlegm blended with blood stasis”,to explore the mechanism and treatment of breast cancer related lymphedema[J].,2023,(10):1420-1423.[doi:DOI:10.3969/j.issn.1000-7369.2023.10.019]
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基于“痰夹瘀血”理论探讨乳腺癌相关淋巴水肿因机治疗
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2023年10期
页码:
1420-1423
栏目:
学术探讨
出版日期:
2023-10-05

文章信息/Info

Title:
Based on the theory of “phlegm blended with blood stasis”,to explore the mechanism and treatment of breast cancer related lymphedema
作者:
蔡丽珍1; 白瑞娜2; 张 路2; 朱雪莹1; 秦玲利2; 蔡雅杰2
(1.北京中医药大学,北京 100029; 2.中国中医科学院西苑医院,北京 100091)
Author(s):
CAI Lizhen; BAI Ruina; ZHANG Lu; ZHU Xueying; QIN Lingli; CAI Yajie
(Beijing University of Chinese Medicine,Beijing 100029,China)
关键词:
乳腺癌;  淋巴水肿;  痰;  瘀;  热
Keywords:
Breast cancer;  Lymphedema;  Phlegm;  Blood stasis;  Pathogenesis;  Heat
分类号:
R 273
DOI:
DOI:10.3969/j.issn.1000-7369.2023.10.019
文献标志码:
A
摘要:
乳腺癌相关淋巴水肿(BCRL)属中医“水肿”范畴,“虚、毒、瘀、水、痰、热”为其主要病理因素。笔者认为其发生发展过程符合痰瘀致病的复杂性与多变性,以临证为契机,从“痰夹瘀血”理论探析BCRL与痰瘀的关系,以期为临床诊治提供新思路。病机方面,初期络脉受损,气血津液运行不畅,津凝成痰,血郁为瘀; 中期痰瘀互结互化,胶痼不解,聚而成积; 后期痰瘀蕴蓄,化热生火,燔灼气血,酿生毒邪。治疗方面,痰瘀内生治以燥湿化痰、活血利水,痰瘀互结治以化痰消瘀、软坚散结,痰瘀化毒治以祛邪解毒、涤垢化浊,可用二陈汤、四君子汤、四妙勇安汤为底方进行加减。此外,痰瘀之成,非一朝一夕,宿邪宜缓攻,以“缓”遣方用药,攻补兼施,时时顾护正气,缓缓图之。
Abstract:
Breast cancer related lymphedema(BCRL)belongs to the category of “edema” in traditional Chinese medicine,with “deficiency,poison,blood stasis,water,phlegm and heat” as its main pathological factors.The author believes that its occurrence and development process is in line with the complexity and variability of phlegm-stasis pathogenesis.Taking the clinical syndrome as an opportunity,the relationship between BCRL and phlegm-stasis is analyzed from the theory of “phlegm blended with blood stasis”,in order to provide new ideas for clinical diagnosis and treatment.Pathogenesis,the initial choroid damage,qi,blood and body fluid movement is not smooth,jin condensed into phlegm,blood stagnation for stasis.In the medium term,phlegm and blood stasis have become mutually reinforcing,and the chronic accumulation has resulted from chronic incomprehension; later phlegm-stasis storage,heat fire,burnt burning qi and blood,brew poisonous evil.In terms of treatment,endogenous treatment of phlegm-stasis is to dry dampness and reduce phlegm and promote blood circulation and water; phlegm blended with blood stasis are to reduce phlegm and eliminate blood stasis,soft and firm,and phlegm-stasis is to remove evil and detoxify,and to purify dirt and turbidize.Erchen decoction,Sijunzi decoction and Simiao Yong'an decoction can be used as the base for addition and subtraction.In addition,the formation of phlegm-stasis,not overnight,the evil should slow attack,to “slow” prescription medication,attack and complement,always take care of protecting qi,slowly figure.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助面上项目(82174216); 北京市中医药科技发展资金资助项目(JCZX-2020-12)
更新日期/Last Update: 2023-10-09