经腹腔动脉肝动脉泵入华蟾素注射液对肝脏供血系统及脾动脉的影响

【作者】 梁桢桢；

【导师】 胡凯文；

【作者基本信息】 北京中医药大学 ， 中西医结合临床， 2010， 硕士

【摘要】 回顾中医对肿瘤的认识,发现肿瘤是整体辨证属虚,局部辨证属实,整体失调在身体局部的体现,并认识到肿瘤的特点,迁延难愈,异常凶险,《医门补要》日：“惟骨瘤、肉瘤,初起可用火针,插进降条,化尽其根可愈。至已肿大如桃李,决不可动刀针害人。”《本经逢源》则提出先用火针针破石痈,然后再用炼石散同白蔹、鹿角外敷。火针可以灼伤肿瘤组织且不出血,然后再用外敷药可以直达病所。此为古人初步的局部治疗的思想,并采用高温消融治疗,只是受到技术条件限制。西医认为肿瘤是一类以”局部肿块病变”为主的”全身性”疾病,手术治疗肿瘤的疗效较为确切,化疗、放疗及生物治疗存在很多适应症及副作用,另外肿瘤患者的体质特点是脾胃虚弱,内服药,尤其是性味峻烈的毒药使用受到限制,而且副作用较大,从而提出肿瘤外治的优势,中医外治法源远流长,概念：是指运用药物、手术以及其他方法,直接施治于病变部位或体表的一定部位以达到治疗目的治疗方法。传统的方法包括：药物治疗有外敷法、薄贴法、涂搽法、喷吹法、含漱法、吸入法、塞入法、灌注法、熏洗法等；手术治疗包括：决、割、剪、砭、烙、缝等；器械手法治疗如：针法、灸法、热敷法、拔罐法、按摩等,中医学药物外治法对于癌症的治疗,可以简单理解为：中药或中成药通过器械或直接作用于病灶及病灶周围血管或组织而起到治疗作用的方法。纵观西医肿瘤的治疗之路,手术治疗：从传统外科手术,到内窥镜下的手术,到发展迅速的微创治疗包括：微波、DSA、射频消融、冷冻等,再到无创的超声聚焦刀；化疗、放疗、生物治疗、研究中的基因治疗,虽然还有待完善发展,但总的治疗思路是局部治疗,治疗方向是从组织靶向到细胞靶向,再到分子靶向。现代医学治疗肿瘤的核心思想就是针对肿瘤的靶向治疗,中医追溯历史多由外治法发展而来,随着现代科学的发展,外治方法赋予了更多新的内容,其中涉及到一些现代医学技术如透皮吸收技术进步巴布剂、离子导入法等；这些仅限于经皮肤直接给药,还有针刺毁损病灶方法如微波、氩氦刀等,更有借助西医介入治疗技术如中药介入治疗等,故将外治法的内容扩展到局部治疗的范畴。此文对肝癌的局部治疗作以介绍,并对临床应用最广泛的经皮肝动脉灌注化疗栓塞治疗中加以中药结合,采用肝动脉泵入华蟾素的给药方法加以研究,临床观察经腹主动脉肝动脉泵入华蟾素对肝脏供血系统及脾动脉血流动力学方面的影响。推测肝动脉泵入华蟾素引起肝脏供血系统及脾动脉的血流动力学改变符合肝脏的缓冲效应,引起的血流动力学异常可能为华蟾素治疗肝癌的一新的间接作用机制。从中西医结合局部治疗恶性肿瘤的角度研究肝癌发现,中医药的局部治疗具有非常广阔的治疗前景,作为现代中医临床医师,应当结合新技术、新方法、新制剂,从而建立一个完整而科学的中医肿瘤综合治疗体系,这对于中医肿瘤临床事业的发展将具有重要意更多还原

【Abstract】 Recalling the TCM knowing of the tumor, the tumor was in the whole body differentiation is insufficiency, topical differentiation is excessiveness, parts reflect the overall imbalance in the body, and recognizing the characteristics of the tumor is that, protraction and abnormal dangerous. "Yi Men Bu Yao" said:" Only the osteoma, sarcoma, available since the beginning to use the fire needle, inserted into the lower section, Melting its root can be Recover,but to have swelling, looks like peaches and plums, knife needle must not be usde. " "Ben Jing Feng Yuan" is first offer the method that breaking the tumor by fire needles, and then use the refined Powder made by TCM external, Fire needle burns tumors without bleeding, then it can get to nidus treated by the outside. This is the ancients thought about local treatment, Apply high temperature ablation to therapy, but restrainting by the technical conditions. Western medicine know cancer is a type of "systemic" disease,which mainly based on "local mass lesions".It is efficacy by surgery, chemotherapy, radiotherapy and biological therapy.But there are many indications and side effects too. TCM considers physical characteristics of cancer patients are aways stomach weakness, using internal medicine, in particular sexual tasted poison is limited, bringing many side effects, then the advantages of tumor external treatment is obviously.TCM External treatment is long-standing, the concept of which is to use the drugs, surgery and other methods, direct giving treatment in certain lesions or body surface area to achieve the purpose of treatment therapy.traditional methods include: Drug treatment of topical method, a thin paste method,spread method, injection method, rinse method, inhalation, insert method, perfusion; surgical treatment include:cut, acupuncture, bake, sew, etc. equipment manual therapies such as:acupuncture, moxibustion, hot pack method, cupping method, massage, Chinese medicine treatment of drug external treatment for cancer is to impose on body medicine Table skin or body cavity mucosa to the drug through the skin, mucous membrane, aperture and other parts of way directly into the body to play a therapeutic effect. Simply be understood as:Chinese medicine play a therapeutic approach through the device or directly on peripheral vascular lesions or focus organization. Looking at the way Western cancer surgical treatment developt:from traditional surgery to endoscopic surgery, to the rapid development of minimally invasive treatments including:microwave, DSA, radiofrequency ablation, freezing, etc. up to non-invasive Focused Ultrasound Surgery, chemotherapy, radiotherapy, biological therapy, the study of gene therapy, although still to be developed, but the general idea is locoregional therapy, therapeutic approach is targeted treatment which is from tissue targeting, to the molecular target. Modern medical treatment of cancer core idea is that the tumor targeted therapy, Chinese medicine history about it is evolved from the external treatment, with the development of modern science, External treatment to give a new content, Which involves a number of modern medical technology, Babu is a outcome of Transdermal technology development, those are Medication through the skin directly, as well as acupuncture methods such as microwave damage lesions, argon helium knife, even with Western medicine intervention treatment technologies, such as traditional Chinese medicine by intervention, it will extend the content of external treatment to locoregional therapy areas. This article is introduce about local therapy for liver cancer,and TACE is the most extensive clinical application of intervention treatment of hepatic cancer, we combine traditional Chinese medicine to the TACE, adoptedepatic artery pump the Chinese cinobufotalin, to clinically observing and studing the Liver blood supply system’s and Splenic artery’s Hemodynamic changes. Speculated that hepatic artery infusion of the Cinobufotalin cause the abnormal changes, it is just in line with the hepatic arterial buffer response, It may be a new Mechanism Indirectly treat the liver cancer, Integrative Medicine from the perspective of local treatment of liver cancer found that local treatment of Chinese medicine treatment has a very broad outlook, as a modern clinicians of Chinese medicine, should be combined with new technology, new methods, new formulations in order to establish a complete and scientific Traditional comprehensive cancer treatment system, which will be of great significance for the Chinese Clinical Oncology career development.更多还原