中医辨证论治肺结节研究现状与思考

Research progress and thinking of traditional Chinese medicine in the treatment of pulmonary nodules

随着癌症早筛和体检的普及,肺结节检出率日益增多,现有治疗手段以手术切除或定期随访为主。其机制不明,目前尚未有较好的治疗手段,特别是针对临床无手术指征患者,定期随访观察会增加部分患者焦虑恐惧,而此阶段可能会成为中医药介入的绝佳时期,同时现有临床证据也表明中医药防治肺结节具有一定临床疗效,如促进结节消失或缩小,或防止结节恶变,或缓解临床症状等。文章通过检索近20年中医药治疗肺结节相关文献,从病因病机、辨证论治、经验用药等方面归纳总结,并对中医诊疗肺结节现状予以思考展望,以期为中医药防治肺结节提供相关理论基础和临床指导,为肺结节防治提供中医智慧。

With the popularization of early cancer screening and physical examination,the detection rate of pulmonary nodules is increasing.At present,the treatment of pulmonary nodules is mainly surgical resection or regular follow-up.Because its mechanism has not yet been elucidated,there is no better treatment currently available.Especially for patients without clinical indications for surgery,regular follow-up observation will increase the anxiety and fear of some patients.Perhaps,this stage may become an excellent period for Chinese medicine to intervene.At the same time,the existing clinical evidence shows that traditional Chinese medicine(TCM)has a certain effect in the prevention and treatment of pulmonary nodules,such as promoting the disappearance or reduction of nodules,preventing malignant transformation of nodules,or relieving clinical symptoms.By searching related literature on the treatment of pulmonary nodules with TCM in the past 20 years,this paper summarize its etiology and pathogenesis,syndrome differentiation and treatment,and experience medication,and at the same time give a thought and outlook to the current situation.In order to provide relevant theoretical guidance for the prevention and treatment of pulmonary nodules with TCM,it also provides TCM wisdom for the prevention and treatment of pulmonary nodules.