从阳虚血瘀论治妇科肿瘤术后骨关节症状

Treatment of Bone and Joint Symptoms after Gynecological Tumor Operation Based on Yang Deficiency and Blood Stasis

妇科肿瘤患者术后易出现骨关节症状,“阳虚血瘀”为妇科肿瘤术后骨关节症状的关键病机,妇科肿瘤患者体内癌毒积聚,长期耗伤气血,加之手术损伤,气血愈加亏虚,久则及阳,阳虚日久无力温煦,阻滞气血运行,易瘀滞于关节,血脉不通可见骨痛,气血阴阳失于濡养多见关节僵硬等骨关节症状。治疗应重视温阳以通经、活血以除痹,并伴随病程演变分阶段辨治,方选黄芪桂枝五物汤加减,强调活血在临床用药中的关键地位。本文从阳虚血瘀立法,借鉴“痹证”证治思维,冀以丰富其在肿瘤领域的中医理论内涵,指导临床诊疗及提高中医药辨治疗效。

Patients with gynecological tumors are prone to postoperative bone and joint symptoms.Yang deficiency and blood stasis is the key pathogenesis of bone and joint symptoms after gynecological tumor operation.Patients of gynecologic tumor suffer from the accumulation of cancer toxins in their bodies and long-term depletion of qi and blood.In addition to surgical injury,qi and blood become more deficient,and after a long time,it results in yang deficiency.Deficiency of the yang for a long time is unable to warm,and blocking qi and blood,and joint symptoms like bone pain and joint stiffness are caused by the blood stasis and the loss of nourishment of qi and blood in yin and yang in the joint.Treatment should attach importance to warming yang and invigorating blood to treat bone and joint symptoms,differentiate and treat by stages along with the course of disease evolution,select Huangqi Guizhi Wuwu Decoction and emphasize the key role of blood-activating drug in clinical medication.This article established therapeutic principles from yang deficiency and blood stasis and used the thinking of syndrome differentiation and treatment of Bi syndrome for reference,in order to enrich the TCM theory in the field of tumor,guide clinical diagnosis and treatment and improve the therapeutic effect of TCM.