前列腺癌分期论治策略与实践

Staging Based Strategies and Practice for Prostate Cancer

通过10多年的临床实践与研究,笔者提出采取病证结合、因人因时制宜的中西医结合分期论治策略治疗前列腺癌。对早期前列腺癌采取根治性手术"祛邪"为主、围手术期中医"扶正"为辅,促进快速康复的最佳论治策略。对晚期前列腺癌则采取"扶正祛邪"相结合的论治策略。包括对激素依赖型前列腺癌采取内分泌治疗与中医药协同增效相结合的综合治疗方案,改善生活质量,延缓转化为去势抵抗前列腺癌的时间,甚至达到临床治愈的目的。而对于目前缺乏有效西药和方法治疗的去势抵抗型前列腺癌,则主要以中医药大补元气为法,以改善临床症状、延长生存期为目的。实践证明针对前列腺癌的中西医结合分期论治策略具有很好的疗效优势,尤其是在延长晚期前列腺癌患者生存期、延缓病情进展等方面显示出中西医结合的良好前景,并可为如何实践"病证结合"提供有益的思考和启迪。

Authors raised that staging based strategies and practice of integrative medicine（IM） by combining syndrome typing and disease identification,and choosing suitable measures in accordance with different persons and seasonal conditions after more than ten years＇ clinical practice and researches.Radical operation as prior（as evil eliminating） and strengthening vital qi in perioerative period are best strategy for promoting rapid rehabilitation of early stage prostate cancer patients.Strengthening body resistance to eliminate evil was used in treating advanced prostate cancer patients.For example,a comprehensive treatment program for hormone-dependent patients was combined with endocrinotherapy and Chinese herbs for synergisic efficacy-enhancing actions.In this way,these patients＇ quality of life（QOL） were improved and time to castration resistant prostate cancer（CRPC） was delayed,even some patients were clinically cured.There are lack of effective medicines and methods for CRPC patients.Greatly tonifying original qi is mainly used for improving their clinical symptoms and prolonging survivals.Practice has proved staging based strategies and practice of IM has favorable advantages in treating prostate cancer,especially showing prospect in prolonging survival and postponing progression of advanced prostate cancer patients.Besides,it also could provide beneficial considerations and inspiration for combination of syndrome typing and disease identification.