【作者】 陈玉超；

【导师】 刘沈林；

【作者基本信息】 南京中医药大学 ， 中西医结合临床， 2009， 博士

【摘要】 本论文主要由五个部分组成,在详述姑息治疗对于恶性肿瘤重要性的基础上,初步总结了四个肿瘤相关性症状的中医药辨治精要及刘沈林教授辨治恶性肿瘤的思路和经验。第一部分:明确了姑息医学和姑息治疗的概念、手段,概述了现代医学对姑息医学和姑息治疗在肿瘤治疗中的作用和地位的认知过程。阐述了中医症状控制与肿瘤姑息治疗之间的关系,对中医药辨治在恶性肿瘤姑息治疗中的作用与定位,中医姑息治疗的原则和具体方法及中医药抗肿瘤的优势进行了详细的介绍,并指出中医姑息治疗与症状控制的研究现状和存在问题。第二部分:从现代医学研究及治疗、中医学对相关症状的认知、病因病机分析、主要证型等方面,对肿瘤相关性乏力、肿瘤相关性腹泻、肿瘤相关性便秘、肿瘤相关性汗证的中医药治疗进行了较全面的研究,并对临床辨治要点、注意事宜作了进一步说明。第三部分:对刘沈林教授辨治恶性肿瘤的100例病案进行了初步的分析。其中常见四个症状所占比例进一步说明中医姑息治疗与症状控制在临床肿瘤治疗中的重要性。临床常用补虚扶正,恢复脏器功能,提高机体自身抗病力的治疗方法,充分体现了导师的治疗思路和特色。第四部分:通过现代分子生物学对中医扶正治疗肿瘤理论的解读,从扶正的分子免疫调节作用、补益脾肾对肿瘤多阶段的影响、扶正中药诱导肿瘤细胞凋亡的分子机制、扶正中药诱导肿瘤细胞分化的分子机制、扶正中药对肿瘤多药耐药的逆转分子机制五个方面进一步阐明中医症状控制与肿瘤治疗的统一性、科学性。为肿瘤相关症状的中医药辨治提供科学依据。第五部分:选取四个典型病案,经过中医药的准确辨治,在较短时间内消除了病人的痛苦。通过对其理法方药的分析,进一步说明中医主症论治在肿瘤相关性病症中的重要作用,也为临证治疗示以范例。更多还原

【Abstract】 There have five parts in my assay. On the base of demonstrating the importance of alleviative treatment, I summarized four cancer-related symptoms essence of TCM differentiation of symptoms and signs. I also summarized Professor Liu Shenlin’s thought and experience of treating tumor.Part one, the concept and means of palliative medicine and alleviative treatment were overviewed. The role and position of alleviative medicine and alleviative treatment in modern medicine were outlined. Then relation between controlling TCM symptom and tumor’s alleviative treatment was explained. At the end of this part, the principle of TCM alleviative treatment and the superiority of tumor therapy with TCM were introduced and researching status quo and present question of TCM alleviative treatment were pointed out.Part two, on the direction of therapy of modern medicine, recognition of TCM’s symptom, analysis of etiopathogenisis and pathogensis and type of syndrome, fatigue, diarrhea, constipation and hidrosis syndrome related tumor treatment with TCM were researched all around. The highlight and the announcements of clinical differentiation of symptoms and signs were also explained.Part three, 100 cases of tumor that were treated by Professor Liu Shenlin were analyzed preliminary. The result was that four symptoms had high percent of all symptoms. This result accounts the importance of clinical tumor’s treatment with TCM alleviative treatment. Method of reinforcing deficiency and strengthening body resistance was used for retrieving function of organ and elevating resistant-illness power and this method show off Professor Liu Shenlin’s thoughts and feature.Part four, by readout tumor therapy’s theory of TCM with molecular biology, I illuminated the uniformity and scientific characteristics between controlling TCM symptom and tumor therapy from five directions. There are immunoregulation of strengthening body resistance, reinforcing spleen and kidney’s influence on onset and start of tumor source, molecule mechanism of Chinese medicine induced tumor cellular apoptosis, molecule mechanism of Chinese medicine induced tumor cellular differentiation and molecule mechanism of Chinese medicine reversing tumor multi-drug resistance.Part five: Select four typical cases, after an accurate differentiation of symptoms and signs of TCM, the suffering of patients was eliminated in short time. Through the analysis of reason, method, prescription and medicine, the important role of differentiation of main symptoms was illustrated further, as well as clinical treatment to show an example.更多还原