形神医学与恶性肿瘤疗效评价标准

Body-spirit Theory of Medicine and Evaluation Criteria of Therapeutical Effect of Malignant Tumor

中医形神医学理论与恶性肿瘤诊治显著相关。提出恶性肿瘤治疗形神统一理论(绝对统一和相对统一),将恶性肿瘤发展过程及相对应的治疗分为三期,创建更加合理、有效的综合治疗及疗效判定标准。早期以治形为中心,追求形神绝对统一,评价重点在根除瘤体(CR,Recist判定标准)+症状消失;晚期以治神为重点,追求形神相对统一,评价重点在症状、合并症出现少而轻,忽略肿瘤增大至进展(PD);中期前半部分,评价重点在瘤体缩小(CR、PR、肿瘤缩小的SD)+症状改善,与早期治疗目标接近;后半部分评价重点在症状明显减少+瘤体增大速度减慢(肿瘤增大的SD、PD),与晚期治疗目标相衔接。理论研究与临床应用结合,为临床应用服务,先行创建形神统一非小细胞肺癌疗效评价标准,根据疗效判定结果调整临床治疗。未来期待根治和姑息两大类治疗,全方位、多角度、分期、分阶段、多项目、多指标综合评价恶性肿瘤治疗效果。

The body-spirit theory of TCM is significantly correlated with the diagnosis and treatment of cancer. So a body-spirit theory （ relativeness and absoluteness ） of treatment of malignant tumor is put forward for setting the reasonable and feasible evaluation standard of therapeutical effect of malignant tumor, which divides tumor progress into three periods.It is priorit to cure the body （ body-spirit theory ） and achieve absolut unity of body-spirit in the early stage of tumor. Evaluation is the focus of tumor eradicated curative （ CR, Recist ） and symptom complete remission.But it is priorit to cure the spirit （ body-spirit theory ） and relative unity of body-spirit in advanced tumor. Evaluation is the focus of improving symptom and reducing complications, regardless of tumor progression.In the first half of intermediate stage cancer, evaluation is the focus of reduction of tumor （ CR, PR, SD ） and symptom improvement, which is similar to the early goal.During the latter half of intermediate stage cancer, evaluation is the focus of symptoms relieved and growth slowed of tumor, which is near to the advanced goal.To set up the NSCLC efficacy evaluation criteria of body- spirit theory firstly and adjust clinical treatment according to the resuh, which is the combination of theoretical research and clinical application for clinical practice.Effects on cancer care shoMd be rated by cnmprehensive, multi- index evaluation according to radical and palliative treatment in the future.