基于中医证素辨证的恶性腹腔积液综合治疗方略

Comprehensive Treatment Strategy and Method for Malignant Ascites Based on Syndrome Factor Differentiation of Traditional Chinese Medicine

本文试从“恶性腹腔积液(MA)的治疗现状”“MA的中医辨证论治源流”以及“基于证素辨证的MA综合治疗方略”3个方面,结合临床体悟,以证素辨证为切入点,提出了MA联合中医药综合治疗的方法和策略。认为运用证素辨证有利于MA的个体化综合治疗;其病位因素多责之肝、脾、肾等脏腑;病性多以癌毒、水饮为核心,证素多端,如兼有气滞、血瘀、痰阻、湿滞、阳虚、阴虚、实热、实寒等虚实之变;证素辨证亦可用于指导外治用药,内外兼治可提高疗效。总之,证素辨证可拓展MA的治疗空间,促进MA的综合治疗,提高患者的生活质量,值得深入研究。

In this paper,the authors attempted to propose the methods and strategies for the comprehensive treatment of malignant ascites(MA)combined with syndrome factor differenctiation of traditional Chinese medicine based on their clinical experiences,which is from the following three aspects,“the treatment status of MA”,“the source of syndrome differentiation and treatment of MA”and“the comprehensive treatment strategies and methods based on syndrome factor differentiation”.It is believed that the use of syndrome factor differentiation is beneficial to the individualized comprehensive treatment of MA;its disease location factors are responsible for the liver,spleen,kidney and other organs;the disease nature factors are multi-faceted with the core factors of cancer toxin,water and fluid retetion,others relate to qi stagnation,blood stasis,phlegm obstruction,wet stagnation,yang deficiency,yin deficiency,excessheat,excess cold and other factors of deficiency or excess,syndrome factor differentiation can also be used to guide external treatment,and could improve the efficacy with internal treatment.In short,syndrome factor differentiation can expand the treatment space of MA,promote the comprehensive treatment of MA,and improve the quality of life of patients,which is worthy of further study.