张爱琴论治涎腺腺样囊性癌经验及验案分析

ZHANG Ai-qin’s Experience and Case Analysis in Treating Salivary Adenoid Cystic Carcinoma

涎腺腺样囊性癌是病死率非常高的上皮性肿瘤,目前主要治疗方法是手术切除辅助术后放疗,其恶性生物学特点导致手术切除时难以获得明确的边界,术后常出现远处转移,放疗亦带来许多并发症,导致生活质量下降、预后较差。张爱琴基于多年临床经验认为,该病的病机关键在于气机失调,病理因素是痰凝、血瘀、癌毒。其在该病的诊疗过程中,主张用药平和,善用气药,强调益气健脾、调气和胃、补气养阴,以达到“健脾固本,调和气机”之效,并针对其易复发转移的特点适时祛邪,同时重视身心同调,提高患者生活质量,临床疗效显著。

Salivary adenoid cystic carcinoma is an epithelial tumor with high mortality.The main treatment is surgical resection assisted by postoperative radiotherapy.Its malignant biological characteristics make it difficult to obtain a clear boundary during surgical resection,and distant metastasis often occurs after surgery.Radiotherapy also brings many complications,leading to the deterioration of quality of life and poor prognosis.Based on years of clinical experience,ZHANG Ai-qin believes that the key mechanism of this disease lies in the imbalance of Qi,and the pathological factors are spittoon coagulation,blood stasis,cancer and poison.In the process of diagnosis and treatment of the disease,Professor Zhang advocated the use of peaceful medication,making good use of Qi medicine,emphasizing replenishing Qi to invigorate the spleen,regulating Qi to harmonize stomach,supplementing Qi to nourish Yin,so as to achieve the effect of"strengthening the spleen and consolidating the essence and harmonizing the Qi machine".She also aimed at the characteristics of its relapse and metastasis,remove the evil timely.At the same time,she pays attention to the harmony of mind and body,improves the quality of life of patients,and has achieved remarkable clinical effects.