基于国医大师癌毒病机理论研究老年弥漫大B细胞淋巴瘤临床干预范式

Study on Clinical Intervention Paradigm of Diffuse Large B-cell Lymphoma in the Elderly Based on Traditional Chinese Medicine Veteran's Cancer-toxicity Theory

弥漫大B细胞淋巴瘤是一种侵袭性非霍奇金淋巴瘤,其中老年患者发病率高,组织器官严重退化、全身并发症多,临床特征多变,误诊率高,确诊时多处于分期较晚阶段,预后极差。目前一线化疗联合分子靶向治疗在老年患者中面临治疗不耐受、并发症多、易复发耐药等临床难点。针对老年弥漫大B细胞淋巴瘤临床实践中的现状及难点,结合国医大师周仲瑛癌毒病机理论,系统阐释该病的病因病机、辨治要点、整合中西医治疗的优势及治疗策略,结合新药时代老年患者分层管理理念,以及本中心淋巴瘤真实世界临床干预实践,为广大中医临床工作者提供理法方药齐备的全程管理模式,以癌毒病机理论指导老年弥漫大B细胞淋巴瘤的整合治疗,建立更加系统的临床干预范式。从而改善患者脏器功能,控制并发症,减少复发,提高生命质量,发挥中医药减毒增效的独特优势、达到节约医疗成本的目的。

Diffuse large B-cell lymphoma is an aggressive non-Hodgkin's lymphoma,with high incidence among elderly patients.The disease is characterized by seriously degraded organs,multiple systemic complications,and variable clinical features.Due to high misdiagnosis rate,patients are mostly in the late stage of the disease when diagnosed,and have poor prognosis.At present,the first-line chemotherapy combined with molecular targeted therapy adopted in elderly patients has treatment intolerance,multiple complications,easy recurrence,drug resistance,and other clinical problems.In view of the current situation and difficulties in the clinical practice of diffuse large B-cell lymphoma in the elderly,and in combination with traditional Chinese medicine(TCM)veteran Zhou Zhongying's cancer-toxin theory,this paper systematically explained the etiology and pathogenesis of the disease and the key points of syndrome differentiation and treatment,and summarized the advantages and strategies of integrated Chinese and Western medicine treatment.In addition,combined with the concept of layered management of elderly patients in the era of new drugs and the real-world clinical intervention practice of lymphoma in the center,this paper provided the whole process management mode with complete principles,methods,prescriptions and drugs for the majority of TCM clinical workers,guided the integrated treatment of diffuse large B-cell lymphoma in the elderly based on cancer-toxin theory,and established a more systematic clinical intervention paradigm.It was expected to achieve the medical goals of enhancing organ functions of patients,controlling complications,reducing recurrence,improving quality of life,giving full play to the unique advantages of TCM in reducing toxicity and increasing efficiency,and saving medical costs.