前列腺偶发癌联合雄激素阻断后辨治四法

Four Methods of Syndrome Differentiation and Treatment for Incidental Prostate Cancer Combined with Androgen Blockade

前列腺偶发癌(IPC)临床常见脾肾两虚、湿热毒蕴、痞热瘀结、气阴两虚等证型,中医药治疗IPC不离扶正祛邪之宗旨,法当调节免疫以扶正、减毒抗癌以祛邪。结合国医名师徐荷芬临床诊疗经验,以“扶正固本、养阴祛瘤”学术思想为纲,“期型分治”为目,探讨IPC不同时期不同证型的辨治方法,概括为温脾补肾、清热燥湿、化痞破瘀、益气养阴等治法;强调带瘤生存,引入生存质量评价,生存质量应包含生活质量和患者满意度,完善IPC疗效评价体系。

In incidental prostate cancer(IPC),the common syndromes are deficiency of spleen and kidney,accumulation of damp-heat toxin,binding of pi and heat,and deficiency of qi and yin.For IPC,the treatment of traditional Chinese medicine(TCM)usually aims at reinforcing healthy qi and dispelling evil qi,and involves regulating immunity to reinforce healthy qi,reducing toxin and fighting against cancer to dispel evil qi.Based on the clinical experience of distinguished TCM master,XU Hefen,with the academic thought of“reinforcing healthy qi and consolidating the root,nourishing yin and removing tumors”as the guideline,and“treatment based on stages”as the classification,the differentiation and treatment methods of different IPC syndromes in different stages were discussed,which are summarized as warming the spleen and tonifying the kidney,clearing away heat and drying dampness,removing pi and breaking stasis,boosting qi and nourishing yin.Survival with tumors has been emphasized,and the evaluation of the survival quality has been introduced,which consists of life quality and patient satisfaction.By doing that,the IPC efficacy evaluation system was improved.