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2021, 12, v.40;No.410 1297-1301
《金匮要略》类方在肝癌治疗中的应用
基金项目(Foundation): 国家重点研发计划项目(编号:2017YFC1700606)
邮箱(Email):
DOI: 10.16295/j.cnki.0257-358x.2021.12.003
摘要:

肝癌属中医学黄疸、肝积、癥瘕等范畴,《金匮要略》经方在以上疾病的现代临床中应用颇多,常见有柴胡类方、大黄类方、茵陈类方、建中类方等。柴胡类方中小柴胡汤多用于肝失疏泄、肝气郁滞之腹满、黄疸者,大柴胡汤多用于肝郁血瘀、腑气不通之腹部胀满、疼痛者;大黄类方中大黄?虫丸常用于内虚夹瘀者,大黄附子汤用治寒实内结、气滞不运所致肝癌胁腹疼痛等,栀子大黄汤可治湿热内蕴偏热盛所致的肝癌黄疸;茵陈类方中茵陈蒿汤治疗湿热结毒所致肝癌黄疸,茵陈五苓散可用于治疗肝癌腹水;建中类方可用于手术或放化疗后益气扶正、止痛;薯蓣丸方取丸药缓图之意,可用于肝癌晚期或恢复期;另有软坚散结之鳖甲煎丸在肝癌的防治中亦有显著疗效。

Abstract:

Liver cancer usually invo lves the disease such as jaundice,liver accumulation and abdominal mass in traditional Chinese medicine(TCM). Classical formulas from Synopsis of Golden Chamber are widely applied in the treatment of the diseases mentioned above in clinic,such as Chaihu group formulas,Dahuang group formulas,Yinchen group formulas,and Jianzhong group formulas. In Chaihu group formulas,Xiaochaihu Decoction(小柴胡汤) is usually used for abdominal distention and jaundice due to liver failing to regulating or liver qi stagnation,while Dachaihu Decoction(大柴胡汤) is usually applied for abdominal distention and pain due to liver qi stagnation,blood stasis or blocked fu qi;in Dahuang group formulas,Dahuang Zhechong Pill ( 大黄?虫丸 ) is usually used for internal deficiency with stasis,while Dahuang Fuzi Decoction( 大黄附子汤 ) is for pain in hypochondria and abdomen due to cold accumulating inside or qi stagnation in liver cancer patents, Zhizi Dahuang Decoction ( 栀子大黄汤 ) is for jaundice due to accumulated damp heat with excessive heat in patients with liver cancer;in the Yinchen group formulas,Yinchenhao Decoction ( 茵陈蒿汤 ) is applied for jaundice due to accumulated and intermingled dampness,heat and toxin,and Yinchen Wuling Powder (茵陈五苓散 ) is for ascites caused by liver cancer;Jianzhong group formulas could be applied for invigorating and supplementing healthy qi and relieving pain after surgery,radiotherapy or chemotherapy;Shuyu Pill(薯蓣丸) could be applied for liver cancer in the later stage or the recovery stage for it could work gradually on patients;Biejiajian Pill(鳖甲煎丸) with the function to soften hardness and dissipate mass is of significant effect in the prevention and treatment of liver cancer.

参考文献

[1] BRAY F,FERLAY J,SOERJOMATARAM I,et al. Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin,2018,68(6):394-424.

[2]陈万青,李贺,孙可欣,等. 2014年中国恶性肿瘤发病和死亡分析[J].中华肿瘤杂志,2018,40(1):5-13.

[3]贺君剑,魏长慧,李众,等.中国居民2004—2016年肝癌死亡趋势分析[J].郑州大学学报(医学版),2020,55(1):119-122.

[4]史话跃,吴承玉.基于关联规则的肝癌证候与病位病性的相关性研究[J].北京中医药大学学报,2017,40(10):876-880.

[5]周晓萍,张玲,吴君荣.原发性肝癌患者症状体征与血清AFP关系的探讨[J].中国临床新医学,2018,11(2):128-133.

[6]中华人民共和国国家卫生健康委员会医政医管局.原发性肝癌诊疗规范(2019年版)[J].临床肝胆病杂志,2020,36(2):277-292.

[7]董筠,周仲瑛.运用《金匮要略》理念辨治肿瘤的实践体会[J].江苏中医药,2018,50(11):50-52.

[8]陈万青.重视我国癌症年龄变化开展有效应对措施[J].中华预防医学杂志,2018,52(6):561-563.

[9]张卫华,彭树灵.正虚与老年恶性肿瘤关系研究[J].新中医,2012,44(7):16-18.

[10]周岱翰.论《伤寒杂病论》奠定中医肿瘤临床基础与经方运用[J].新中医,2016,48(1):1-3.

[11]温桂荣.经方治肝癌的临床运用[J].中华中医药学刊,2007,25(9):1954-1956.

[12]张驰,王军.原发性肝细胞癌经方论治管见[J].长春中医药大学学报,2018,34(5):908-910.

[13]郝腾腾,吴煜,蔡琳琳,等.大柴胡汤辨证与辨病治疗肝癌体会[J].中国中医药信息杂志,2019,26(3):125-127.

[14]舒遵华,王慧林,刘扬扬,等.大黄素抗肝癌作用机制的研究进展[J].吉林中医药,2020,40(2):278-280.

[15]罗兰,王莹.大黄素抗肝癌作用机制及临床应用[J].中医肿瘤学杂志,2019,1(4):80-82.

[16]陈宏斌.恩替卡韦联合大黄蛰虫丸治疗乙型肝炎肝纤维化的临床效果[J].临床医学研究与实践,2018,3(5):133-134.

[17]洪海龙.恩替卡韦联合大黄蛰虫丸治疗乙肝肝硬化的临床观察[J].医学理论与实践,2019,32(7):1003-1005.

[18]刘旭东,赵壮志,吕萍,等.大黄蛰虫丸联合抗病毒药物治疗乙肝肝硬化疗效的Meta分析[J].时珍国医国药,2018,29(7):1594-1597.

[19]张希琼.大黄蛰虫丸抗肝癌活性成分筛选及其药动学研究[D].南京:南京中医药大学,2019.

[20]李自波,姚静静,杜振华,等.新加大黄附子汤对小鼠原位移植肝癌的治疗作用[J].河南大学学报(医学版),2017,36(3):156-159.

[21]杨战锋,李晓勇,周百中,等.栀子大黄汤对酒精性脂肪肝大鼠的保护作用[J].吉林大学学报(医学版),2017,43(3):555-560,669.

[22]陈科霖.栀子大黄汤对ANIT诱导的肝内胆汁淤积大鼠的保护作用及其药效物质研究[D].沈阳:沈阳药科大学,2014.

[23]谭婷,何栋,朱红梅,等.茵陈五苓散对非酒精性脂肪性肝病模型大鼠RBP4的影响[J].中医学报,2020,35(2):344-347.

[24]爨国庆.中医辨证治疗晚期原发性肝癌临床研究[J].中医学报,2016,31(6):777-779.

[25]苏林红,柳侠平,林军.茵陈五苓散对肝硬化腹水大鼠模型的影响[J].中国现代应用药学,2020,37(2):161-164.

[26]张伟.茵陈五苓散加减治疗肝硬化难治性腹水的临床疗效分析[J].中国医药指南,2018,16(13):222-223.

[27]朱昌周,李华.茵陈五苓散治疗肝硬化难治性腹水65例临床观察[J].内蒙古中医药,2010,29(9):32.

[28]蒋曼君,黄彬.薯蓣丸在内科疾病中的应用概况[J].湖南中医杂志,2014,30(12):168-169.

[29]欧阳钦,吴春明.薯蓣丸不同组分提取物对人肝癌HepG2细胞增殖和凋亡的影响[J].浙江中医杂志,2015,50(3):176-178.

[30]刘思鸿,李莎莎,侯酉娟,等.《金匮要略》鳖甲煎丸临床应用的古今文献研究[J].中国实验方剂学杂志,2020,26(6):12-17.

[31]韩中颖,韩政,祝峻峰.韩哲仙消瘀软坚法治疗原发性肝癌临床经验[J].北京中医药,2017,36(3):248-250.

[32]贺松其,姚飞龙,程旸,等.鳖甲煎丸抗肝癌转移的理论依据及分子机制探讨[J].中华中医药杂志,2011,26(11):2579-2581.

[33]施贝德,唐婷婷.中晚期原发性肝癌中医姑息治疗临床观察[J].辽宁中医杂志,2013,40(9):1855-1856.

[34]安海燕,林俊豪,孙海涛,等.鳖甲煎丸通过RhoA/ROCK信号通路抑制肝癌细胞血管形成拟态的生成[J].南方医科大学学报,2018,38(8):997-1001.

[35]铁明慧,张颖,王科.鳖甲煎丸对肝癌皮下转移瘤小鼠肿瘤新生血管及微环境的影响[J].中医杂志,2018,59(4):325-328.

[36]孙阳,吴勃岩,车艳新,等.鳖甲煎丸诱导肝癌细胞凋亡及对STAT信号通路的影响[J].时珍国医国药,2016,27(4):849-851.

[37]孙阳,陶雪莲,解颖,等.鳖甲煎丸含药血清对SMMC-7721肝癌细胞凋亡的影响[J].中成药,2019,41(11):2757-2760.

[38]高业博,李卫东,刘瑞,等.鳖甲煎丸化裁方对肝癌HCCLM3细胞增殖和凋亡的影响[J].北京中医药大学学报,2018,41(6):471-475.

[39]贾文燕,贺松其,文彬,等.鳖甲煎丸对肝癌细胞周期及Wnt/β-catenin信号通路中β-catenin、COX-2蛋白表达水平的影响[J].中华中医药杂志,2015,30(8):2964-2967.

基本信息:

DOI:10.16295/j.cnki.0257-358x.2021.12.003

中图分类号:R273

引用信息:

[1]邹建华,肖战说,李刘生,等.《金匮要略》类方在肝癌治疗中的应用[J],2021,40(12):1297-1301.DOI:10.16295/j.cnki.0257-358x.2021.12.003.

基金信息:

国家重点研发计划项目(编号:2017YFC1700606)

投稿时间:

2020-07-20

投稿日期(年):

2020

终审时间:

2020-10-12

终审日期(年):

2020

审稿周期(年):

1

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