活血化瘀法在乳腺癌术后放化疗后的临床应用

Clinical Application of Promoting Blood Circulation and Removing Blood Stasis in Breast Cancer Patients after Operation and Chemoradiation

[目的]探讨活血化瘀法在乳腺癌术后放化疗后的临床应用。[方法]通过查阅文献,结合临床实际,总结乳腺癌患者术后放化疗后血瘀证的病因病机和活血化瘀法的作用机制,分析临床治疗乳腺癌血瘀证活血化瘀药物种类、剂量及时机选取原则,并举验案以佐证。[结果]手术、放化疗及肿瘤本身均可引起血液流变学改变,导致乳腺癌患者出现血液高凝状态。体虚邪实是乳腺癌患者血瘀证的主要病因病机;活血化瘀药物能够抗肿瘤、减轻放化疗毒副反应、防治术后并发症和肿瘤复发转移;临床中治疗乳腺癌血瘀证应遵循辨证选取活血化瘀药物、选择治疗时机及选择适当剂量的原则,以保护正气。所举验案中患者辨证为脾气亏虚、湿热瘀阻,治以益气健脾、活血化瘀、清热化湿,获得较好的效果。[结论]乳腺癌患者术后放化疗后易出现血液瘀滞,辨证运用活血化瘀法,可明显改善患者临床症状,提高生活质量。

[Objective]To explore the clinical application of the method of activating blood circulation to remove blood stasis in breast cancer patients after operation and chemoradiation.[Methods]By referring to literature and combining with clinical,the etiology and pathogenesis of blood stasis syndrome in breast cancer patients after operation and chemoradiation and the mechanism of the method of promoting blood circulation was summarized.The selection principles of drugs for removing blood stasis,dose and timing in the clinical treatment of blood stasis syndrome of breast cancer patients were analyzed.Finally,one case was presented as proof.[Results]The operation,chemoradiation and the tumor itself can cause hemorheological changes,leading to high blood coagulation in breast cancer patients.The main etiology and pathogenesis of blood stasis in breast cancer patients is the body weakness and the excessiveness of pathogen.The drugs for promoting blood circulation and removing blood stasis have the effects of anti-tumor,reducing the toxic and side effects of radiotherapy and chemotherapy,preventing and treating postoperative complications and tumor recurrence and metastasis.Treating blood stasis syndrome in the clinical should follow the principle of selecting drugs,choosing time of therapy according to syndrome differentiation and the dose of drugs should be small for promoting blood circulation and removing blood stasis to protect the vital Qi.The patient in the case was syndrome differentiated as deficiency of spleen Qi,dampness heat and stagnation of blood stasis,and finally achieved good results after invigorating Qi and strengthening spleen,promoting blood circulation to dissipate blood stasis,and clearing away heat and eliminating dampness.[Conclusion]Breast cancer patients after operation and chemoradiation are prone to blood stasis,and dialectically using the method of promoting blood circulation and removing blood stasis can significantly alleviate the clinical symptoms and improve the quality of life.