战丽彬教授治疗癌因性疲乏的学术思想和临床经验总结

发布时间：2018-03-26 17:43

本文选题：战丽彬　切入点：学术思想　出处：《大连医科大学》2016年硕士论文

【摘要】：目的:本研究通过系统收集、整理战丽彬教授2014年至2015年门诊诊治的癌因性疲乏患者的病案,分析典型病案,总结导师的学术思想、临床经验、用药规律与特色,传承与弘扬中医学术思想,为临床治疗癌因性疲乏提供参考与指导。方法:本研究分为两部分:第一部分,通过研读中医经典古籍和现代文献研究,临床侍诊和导师传授,整理、分析、总结出导师在治疗癌因性疲乏方面的学术思想;第二部分,通过系统收集战丽彬教授2014年至2015年门诊诊治的恶性肿瘤患者的病案,整理存在癌因性疲乏的患者的病案,进行分类、归纳,计算出癌因性疲乏的发病率,研究其处方用药的规律与特色,详细分析三例临床典型病案,分析导师对甲状腺癌、肺癌、宫颈癌患者的癌因性疲乏的辨证论治及遣方用药,总结导师治疗癌因性疲乏的临床经验。结果:第一部分,总结出导师在治疗肿瘤患者的癌因性疲乏方面的五大学术思想,即“研读经典、精于临床”,“虚则补之、损者益之”,“屡攻屡补、以平为期”,“尤重脾阴、从脾论治”,“善调情志、改善睡眠”。第二部分,收集的58例恶性肿瘤患者中,存在癌因性疲乏的患者有38例,发病率为66%。研究分析这38例患者的病案,并结合详细分析导师对甲状腺癌、肺癌、宫颈癌患者的癌因性疲乏这三例临床典型病案的辨证论治与遣方用药,总结出导师在治疗肿瘤患者的癌因性疲乏方面的临床经验,导师善用生黄芪、党参、白术、茯苓、炙甘草,恰是化裁于有着“天下补气第一名方”之美誉的四君子汤,其中生黄芪、党参,白术、茯苓,是导师临床常用的两个核心药对,诸方配伍炙甘草,处方时以四君子汤为基础,另重用生黄芪,根据正虚的程度、疲乏的程度、各症状的缓急以及与癌因性疲乏的关系,处方用药随症加减。导师还擅用白花蛇舌草、半枝莲、半边莲、山慈菇这一清热解毒抗肿瘤的药物组合。此外,导师重视情志的调理和睡眠的改善对治疗癌因性疲乏的重要性,常用陈皮、清半夏这一药对疏理气机、调畅情志,生龙骨和生牡蛎这一药对改善睡眠。其用药规律具有四大特色,即“补气健脾以扶正”、“清热解毒抗肿瘤”、“疏理气机调情志”、“重镇安神助睡眠”,此与第一部分相呼应。结论:导师重视中医经典,精于临床实践,对中医虚劳的经典理论有着深刻且独到的见解;对癌因性疲乏的临床治疗有着丰富且独特的临床经验及诊疗风格。导师重视辨病与辨证相结合,传统中医药与现代药理学研究相结合,中西医学各自的优势和特长相结合,应用于临床,获得显著疗效。
[Abstract]:Objective: through systematic collection, this study collated the medical records of cancer related fatigue patients diagnosed and treated by Professor Zhan Libin from 2014 to 2015, analyzed the typical cases, summed up the academic thoughts, clinical experiences, drug use rules and characteristics of the tutor. Methods: this study is divided into two parts: the first part, through the study of traditional Chinese medicine classical books and modern literature research, clinical consultation and mentor teaching, Sorting out, analyzing and summarizing the academic thoughts of the tutor in the treatment of cancer-related fatigue. Part two, through systematically collecting the medical records of malignant tumor patients diagnosed and treated by Professor Zhan Libin in the outpatient clinic from 2014 to 2015. Sorting out the medical records of patients with cancer-induced fatigue, classifying, summing up, calculating the incidence of cancer-induced fatigue, studying the law and characteristics of prescribing drugs, analyzing in detail three clinical typical cases, analyzing mentors' views on thyroid cancer and lung cancer. Diagnosis and treatment of cancer-induced fatigue in patients with cervical cancer and prescription, the clinical experience of tutor in treating cancer-induced fatigue was summarized. Results: in the first part, five major academic thoughts of tutor in the treatment of cancer-related fatigue of cancer patients were summarized. That is, "to study the classics, to be good at clinical practice," "to make up for the deficiency, to benefit the injured", to "repeatedly attack and compensate for the same period of time", "to pay special attention to the spleen yin, to treat the spleen from the spleen", "to adjust emotions and improve sleep". Part two, of the 58 patients with malignant tumors collected, There are 38 patients with cancer-related fatigue, with an incidence of 66.The study analyzed the medical records of these 38 patients, and combined with detailed analysis of mentors for thyroid cancer, lung cancer, Cancer related fatigue of cervical cancer patients: differentiation and treatment of three typical clinical cases and prescriptions, summing up the clinical experience of tutor in the treatment of cancer-induced fatigue of cancer patients, tutors to make good use of Astragalus membranaceus, Codonopsis, Atractylodes macrocephala, Poria cocos, Grilled licorice is precisely a four-gentleman soup with the reputation of "replenishing qi first in the world". Among them, Astragalus, Codonopsis, Atractylodes macrocephala, Poria cocos, are the two core drug pairs commonly used by mentors in clinical practice. The prescription is based on the Sijunzi decoction and reused the raw astragalus. According to the degree of deficiency, the degree of fatigue, the priority of symptoms and the relationship between the symptoms and cancer-related fatigue, the prescription medicine is added or subtracted with the symptoms. The tutor is also good at using Scutellaria chinensis and Scutellaria Scutellariae. In addition, tutors attach importance to the importance of emotional conditioning and sleep improvement in the treatment of cancer-related fatigue. Raw keels and oysters are drugs that improve sleep. They have four characteristics. That is, "tonifying qi and invigorating spleen", "clearing away heat and detoxifying and anti-tumor", "soothing qi and regulating mood", and "focusing on the town to calm the mind and help sleep", which echo the first part. Conclusion: the tutor attaches importance to the classic of traditional Chinese medicine and is good at clinical practice. He has profound and unique views on the classical theory of asthenia and fatigue in traditional Chinese medicine, and has rich and unique clinical experience and diagnosis and treatment style in the treatment of cancer-related fatigue. The tutor attaches importance to the combination of disease differentiation and syndrome differentiation. The combination of traditional Chinese medicine and modern pharmacology, and the combination of Chinese and western medicine with their own advantages and specialties, has been applied to clinical practice and achieved remarkable curative effect.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R273

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