基于癌毒病机理论辨治甲状腺癌

程海波教授团队在传承国医大师周仲瑛癌毒学说基础上提出中医癌毒病机理论。癌毒病机理论认为,甲状腺癌是由水土失宜、情志内伤、饮食不节等因素致气滞、痰凝、血瘀、癌毒聚于颈部而发病。甲状腺癌的主要病理因素为“气、痰、瘀、毒”;病位在颈前,与肝、脾、肾密切相关;“肝气郁滞、痰瘀蕴毒”为其核心病机;病性多为虚实夹杂,疾病后期多为气阴虚损;临证以“抗癌解毒、扶正祛邪”为治疗原则,针对癌毒盛衰及疾病不同分期特点灵活运用疏肝理气、化痰散结、祛瘀解毒、益气养阴等治法。本文以癌毒病机理论为基础探讨甲状腺癌病机演变及相应治法,以期为甲状腺癌辨治提供新思路。

现代中医肿瘤学术思想述评

随着现代中医肿瘤学科的建立,中医药防治肿瘤取得了长足的发展与进步,涌现了一批学术思想与观点。其中,扶正治癌理论、从膜论治理论、带瘤生存理论、癌毒病机理论、固本清源理论、调气解毒理论是目前中医肿瘤领域较有代表性的学说。纵观中医肿瘤学界对于中医名家思想的研究,已经产生出不少成果,但将诸多医家思想同时进行讨论的研究,相对甚少。本文从学术内涵、临床应用两方面对上述创新性理论进行总结研究,为进一步指导中医肿瘤临床实践提供新思路。

中医肿瘤学现代化发展的现状及思考

现代化是中医发展的必然趋势,经过几十年的发展历程,中医肿瘤学现代化研究取得了巨大成就。通过分析中医肿瘤学在理论创新、临床研究、基础研究等方面的发展现状,明确现代科技进步对中医肿瘤学发展的助推作用,同时也看到中医肿瘤现代化研究中尚且存在的问题和难点。纵观中医肿瘤学现代化发展的历程,其发展的关键在于准确把握传承和创新的关系,继承和发扬中医辨治优势,在遵循中医肿瘤学发展规律的基础上融入现代科技理念,积极推动科研模式的转变和方法学的创新,始终以提高临床疗效作为发展的方向,使中医肿瘤学现代化发展真正做到有机融合、有所创新。

以毒攻毒法论治恶性肿瘤

癌毒是恶性肿瘤的病机关键,“祛邪解毒、扶正固本”为恶性肿瘤治疗的基本原则。以毒攻毒法作为“抗癌解毒八法”之一,是恶性肿瘤的临床常用治法。完善以毒攻毒法的理论内涵,可促进癌毒病机理论防治恶性肿瘤的推广和应用。从历史溯源、学术内涵、应用原则、临床应用等方面探讨以毒攻毒法在恶性肿瘤防治中的应用,认为需在符合癌毒亢盛、正气充实的原则下,根据肿瘤分期、分类的不同,使用具有抗癌作用的有毒中药祛除癌毒。

Effect of Aidi injection plus transarterial chemoembolization on primary hepatic carcinoma： a systematic review and Meta-analysis

OBJECTIVE: To assess the efficacy and safety of Aidi injection plus transarterial chemoembolization(TACE) in patients with primary hepatic carcinoma.METHODS: A comprehensive research of seven electronic databases was performed for comparative studies evaluating Aidi injection combined with TACE for primary hepatic carcinoma until September 2016. Two authors independently extracted data and assessed the methodological quality of the included trials using the Cochrane risk of bias tool from the Cochrane Handbook version 5.1.0. Data was synthesized by using Rev Man 5.3 software.RESULTS: Forty-nine studies involving 3435 patients met the inclusion criteria, most of which were low methodological quality. Compared with TACE alone, Aidi injection plus TACE can significantly improve the efficiency rate [RR = 1.33, 95% CI(1.24, 1.43), P < 0.000 01], clinical beneficial rate[RR = 1.25, 95% CI(1.17, 1.33), P < 0.000 01], survival rate [6 months, RR = 1.19, 95% CI(1.09, 1.29), P <0.0001], 12 months, [RR = 1.37, 95% CI(1.24, 1.52),P < 0.000 01], 18 months, [RR = 2.00, 95% CI(1.26,3.20), P < 0.004], 24 months, [RR = 1.44, 95% CI(1.22, 1.70), P < 0.0001], 36 months, [RR = 1.50, 95%CI(1.07, 2.11), P = 0.02 < 0.05], quality of life [RR =1.84, 95% CI(1.64, 2.05), P < 0.000 01] and immune function [CD3+, MD = 11.12, 95% CI(7.93, 14.30),P < 0.000 01], CD4 +, [MD = 10.37, 95% CI(7.29,13.45), P < 0.000 01], CD4+/CD8+, [MD = 0.30, 95%CI(0.07, 0.53), P = 0.01 < 0.05], NK, [MD = 7.49, 95%CI(6.64, 8.34), P < 0.000 01]. A significant improvement was also found in improvement of symptoms[RR = 1.64, 95%CI(1.38, 1.94), P < 0.000 01], leukopenia [RR = 0.60, 95% CI(0.54, 0.66), P < 0.000 01],thrombocytopenia [RR = 0.46, 95% CI(0.34, 0.61),P < 0.000 01], nausea and vomiting incidence [RR =0.66, 95% CI(0.54, 0.81), P < 0.0001), liver damage rate [RR = 0.57, 95% CI(0.42, 0.77), P = 0.0003 <0.05), and kidney damage rate [RR = 0.18, 95% CI(0.05, 0.68), P = 0.01 < 0.05].CONCLUSION: The results suggested that Aidi injection plus TACE significantly improve the clinical effect of TACE, and reduce the incidence of adverse events. However, rigorous multicenter trials with larger size are warranted to further confirm the findings.