尤建良教授运用“隧道逆癌疗法”治疗肝癌经验的临床研究

发布时间：2018-05-30 06:13

本文选题：尤建良教授 + 肝癌　；参考：《南京中医药大学》2016年硕士论文

【摘要】：目的：导师尤建良教授针对肝癌发生发展的规律,用隧道逆癌疗法逆转疾病进展,减轻病人痛苦,提高病人生活质量。本研究以尤师多年治疗肝癌的临床实践为基础,对其“隧道逆癌疗法”治疗肝癌临床经验进行探讨与总结,使之能进一步指导中医药的运用。方法：通过跟师随诊抄方学习,筛选出60例单纯“隧道逆癌疗法”治疗肝癌典型病案,应用统计学方法归纳导师用方、用药数据。并分析用方、用药频次和四气、五味、归经规律,整理并总结导师传授的临证经验和用药心得。同时以20例“隧道逆癌疗法”辅助结合经导管肝动脉灌注化疗术跟20例单纯进行经导管肝动脉灌注化疗术(灌注药物均选用奥沙利铂)进行对比研究,以总结归纳中医药“隧道逆癌疗法”辅助治疗肝癌的临证经验,并验证其临床疗效。结果：病案统计整理方面,60例肝癌病人中,属原发性者有35例,占58%；属转移性者有25例,占42%。总用药179味,总用药次数4864次,以补虚药频次最多,用药频数依次为陈皮185次、白术182次、白芍、茯苓各157次、黄芩151次；总用处方209张,用方频数依次为微调二号方68次、微调三号方66次、小柴胡汤30次、痛泻要方24次等。第一阶段以性温味辛类药物为主,第二、第三阶段以性平味甘类药物为主,常用中药归经以脾经最多、肝经居次。临床对照研究方面,治疗组(“隧道逆癌疗法”辅助结合经导管肝动脉灌注化疗术)在改善体力状况、临床症状、生活质量、化疗毒副作用和降低肿瘤标志物程度上优于对照组(单纯进行经导管肝动脉灌注化疗术),比较有差别(P0.05)而治疗后两组疾病控制率依次是100%与95%,没有统计学意义(P0.05)。结论：导师“隧道逆癌疗法”治疗肝癌第一阶段(打开入口)以痛泻要方或小柴胡汤为基础方,达到稳定疾病进展势头的目的；第二阶段(微调内环境)以微调二号方或微调三号方为基础方,达到平衡机体内部正邪势力的目的；第三阶段(打开出口)以微调二号方或微调三号方合杏蔻橘桔类方为基础方,达到具备去路以排泄的目的；与导师提出的“和法为先,醒脾开胃；辨证辨病,微调平衡；减症止痛,改善微环境；排气发汗,疏通水道；最终逆转癌变”的目标相符,通过逆转癌病因子生长微环境,使病人体质得到加强,使生活质量得到提升,携癌共存。“隧道逆癌疗法”辅助结合经导管肝动脉灌注化疗术治疗肝癌患者能综合改善患者的临床症状,并提高生活质量,值得临床上进行推广。
[Abstract]:Objective: professor you Jianliang used tunnel reverse cancer therapy to reverse the progress of the disease to alleviate the pain and improve the quality of life of the patients in view of the regularity of the occurrence and development of liver cancer. Based on the clinical practice of treating liver cancer for many years, this study discussed and summarized the clinical experience of "tunnel reverse cancer therapy" in treating liver cancer, so as to further guide the application of traditional Chinese medicine. Methods: 60 cases of typical cases of liver cancer treated by "tunnel reverse cancer therapy" were screened out by following up with the teacher, and the statistics were used to sum up the prescriptions used by teachers and the data of drug use. And analyze the prescription, the frequency of medication and four qi, five flavors, the law of return to the classics, collate and summarize the clinical experience and medication experience imparted by the tutor. At the same time, 20 cases of "tunnel reverse cancer therapy" combined with transcatheter hepatic artery infusion chemotherapy were compared with 20 cases of simple transcatheter hepatic artery infusion chemotherapy (oxaliplatin). In order to sum up the clinical experience of TCM tunnel retrograde cancer therapy in the treatment of liver cancer, and verify its clinical efficacy. Results: there were 35 cases of primary liver cancer and 25 cases of metastases in 60 cases of liver cancer. The total number of drugs was 4864, the frequency of tonifying deficiency was the most, the frequency was 185 times of Chen Pi, 182 times of Atractylodes macrocephala, 157 times of Radix Paeoniae Alba, 157 times of Poria cocos and 151 times of Scutellaria baicalensis. Minor adjustment of the third side 66 times, small Bupleurum decoction 30 times, 24 times pain diarrhea. In the first stage, the main drugs were warm-hearted, and the second, the third stage was mainly composed of Gump drugs. The most commonly used Chinese medicine was the spleen Meridian and the second was the liver Meridian. In clinical controlled study, the treatment group ("tunnel reverse cancer therapy" combined with transcatheter hepatic artery infusion chemotherapy) improved physical condition, clinical symptoms and quality of life. The side effects of chemotherapy and the reduction of tumor markers were better than those of the control group (simple transcatheter hepatic artery infusion chemotherapy was performed, the difference was P0.05). After treatment, the disease control rates of the two groups were 100% and 95%, respectively, and there was no significant difference between the two groups (P 0.05). Conclusion: the first stage of "tunnel reverse cancer therapy" is based on Tongxie important recipe or Xiaochaihu decoction in the first stage of treatment of liver cancer, so as to stabilize the progress of the disease. The second stage (fine-tuning the internal environment) is based on trimming the second or third side to achieve the goal of balancing the forces of good and evil within the body; The third stage (opening the exit) is based on the prescription of fine adjustment No. 2 or orange-like square Hingkom, which has the purpose of having the way to go and excreting, to awaken the spleen and appetizer with the "harmony method" put forward by the tutor, to differentiate the symptoms and diseases, and to adjust the balance between the symptoms and the symptoms, and the balance between the two sides. The goal of reducing symptoms and relieving pain, improving microenvironment, exhausting sweating, dredging waterways, reversing canceration finally "is consistent. By reversing the growth microenvironment of cancer factors, the patients' physique is strengthened, the quality of life is improved, and cancer is carried together." "Tunnel reverse cancer therapy" combined with transcatheter hepatic artery infusion chemotherapy can comprehensively improve the clinical symptoms and improve the quality of life of patients with liver cancer, which is worth popularizing in clinic.
【学位授予单位】：南京中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R249;R273

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