论痰在多发性骨髓瘤中医病因病机中的作用

On the Role of Phlegm in Etiology and Pathogenesis of Multiple Myeloma in Chinese Medicine

[目的]从痰的角度探析多发性骨髓瘤病(multiple myeloma,MM)的中医病因病机,以期更全面地认识MM,扩宽临床诊治思路,提高疗效。[方法]系统整理痰的形成、致病特点及现代医学对痰的认识,结合诸多医家对MM病因病机的认识,总结浙江中医药大学附属第一医院50多年临床经验,探析痰与MM病因病机的关系,并附典型病案一则。[结果]MM以肝肾两虚为病理基础,进而可发展为痰瘀互结,临床表现特点与痰病特点相一致,痰在MM的起病过程中形成,又推动了MM的疾病发展,在MM的发生发展中占据了极为关键的地位。所举病案MM患者肝肾两虚、痰瘀互结,予滋补肝肾、化痰逐瘀治疗,获得良效。[结论]痰在MM病因病机中有重要临床意义,根据痰的发生发展及特点来认识MM,能够更好地把握疾病的本质,为MM的临床诊治提供了新的思路。

[Objective] To analyze the etiology and pathogenesis of multiple myeloma（MM） from the perspective of hemorrhoids in order to understand MM more comprehensively, broaden the clinical diagnosis and treatment ideas, and improve curative effect. [Methods] Systematic review of the formation of sputum, pathogenic characteristics and modern medical knowledge of sputum, combined with the understanding of many physicians on the etiology and pathogenesis of MM, summed up more than 50 years of clinical experience in our hospital, and explored the relationship between sputum and MM＇s etiology and pathogenesis, and attached with a typical case. [Results] MM was based on the pathological basis of liver and kidney deficiency, and then developed into a paralysis. The clinical manifestations were consistent with the characteristics of hemorrhoids. The hemorrhoids formed during the onset of MM and promoted the development of MM. Occupy an extremely critical position in the development of MM. This medical case achieved good results based on nourishing the liver and kidney, eliminating phlegm and blood stasis. [Conclusion] According to the occurrence and development of sputum and its characteristics to understand MM, to grasp the nature of the disease better, it has important clinical significance in the etiology and pathogenesis of MM, and provides new ideas for clinical diagnosis and treatment.