《金匮要略》虚劳论治体系在癌因性疲乏中的应用

Application of Therapeutic Principles for Consumptive Disease Recorded in Synopsis of the Golden Chamber in Treating Cancer-related Fatigue

癌因性疲乏是患者在肿瘤疾病过程中,由于肿瘤自身原因或者肿瘤治疗等其他因素导致的主观感觉疲劳的一种疾病,严重影响肿瘤患者生存质量,现代医学尚缺乏有效的治疗办法,多为对症支持治疗,效果往往不甚满意。基于"异病同治"理论,中医论治癌因性疲乏多从虚劳论治。《金匮要略》对于虚劳的论治体系较为成熟,认为发病主责"五劳七伤",治疗重视脾肾,重在建中气,甘温扶阳,明辨虚实,灵活攻补。《金匮要略》中论治虚劳的理法方药对于临床改善癌因性疲乏具有重要的指导意义。

Cancer-related fatigue(CRF), defined as the subjective sensation caused by the tumor itself or by other factors such as tumor treatment,seriously influences the life quality of cancer patients. CRF is now lack of valid treatment with modern medicine, and the treatment for CRF is mostly by symptomatic and supportive treatment, which can not achieve satisfactory therapeutic effect. Based on the theory of homotherapy for heteropathy,traditional Chinese medicine treats CRF with the therapeutic principles for consumptive disease. The treatment system for consumptive disease recorded in Synopsis of the Golden Chamber is fully developed,and the pathogenesis of consumptive disease can be classified into five kinds of overstrain and seven kinds of impairment,so the treatment addresses the importance of spleen and kidney,and the therapeutic principles of strengthening middle-energizer qi,supporting yang with sweet-warm herbs are used on the basis of differentiating deficiency and excess,and flexible utilization of purging and tonifying. The context of academic thoughts for CRF recorded in Synopsis of the Golden Chamber has important clinical significance for relieving CRF.