基于“肺朝百脉”探讨百合病与肺癌相关性抑郁

Treatment of Lung Cancer-Related Depression and Lily Disease Based on the Theory of“Lung Being Connected with All Vessels”

《黄帝内经·素问·经脉别论》中记载:“脉气流经,经气归于肺,肺朝百脉。”肺朝百脉,肺通机体各经脉,助心行血,对气血的运行起到关键作用。而张机在《金匮要略》中对于“百合病”病因有明确描述“百合病者,百脉一宗,悉致其病也”。肺癌癌毒伤肺,肺阴、血脉受损,严重者可致百脉皆伤,进而可出现肺癌相关性抑郁,其状似“百合病”。肺癌相关性抑郁可由虚热伤血,内扰心神所致,其最常见的中医证型为肺阴虚,这与“百合病”心肺阴虚的核心病机十分相符。故可基于“肺朝百脉,百脉一宗,悉致其病也”理论,将百脉损伤所致的百合病补肺养阴治法古为今用,用于肺癌相关抑郁的治疗。经临床实践证实,应用百合地黄汤、百合知母汤等治疗百合病的基础方剂病证结合,加减化裁,可对证型相符的肺癌肿瘤相关性抑郁患者产生良好的治疗效果,为肺癌相关抑郁的证治提供新思路。

Accoring to Special Discussion on Channels and Vessels,Plain Questions,vessel qi flows in the channels and channel qi flows to the lung.The lung is connected with all the vessels.Being connected with all meridians of the body,the lung reinforces the heart and promotes blood movement,thus being pivotal to the movement of blood and qi.As recorded in Synopsis of the Golden Chamber(Zhang Zhongjing),all vessels originate from one root,and any one of them may cause the lily disease.Cancer toxin damages yin and the injury of lung yin and blood vessel will result in the damage of all vessels in severe case and further the lung cancer-related depression.The symptoms of lung cancer-related depression are similar to those of the lily disease.The depression may be caused by deficiency-heat injuring blood and internal heat harassing heart spirit.The common syndrome of the depression is lung yin deficiency,which is consistent with the core pathogenesis(yin deficiency in heart and lung)of lily disease.Therefore,based on the above theory recorded in Synopsis of the Golden Chamber,the lung-tonifying and yin-nourishing method for lily disease(caused by the injury of vessels)can be applied to the lung cancer-related depression.According to the clinical experiment,Baihe Dihuang Decoction,Baihe Zhimu Decoction and other basic prescriptions in the treatment of lily disease are effective for patients with lung cancer-related depression.This study is expected to serve as a reference for the treatment of lung cancer-related depression.