内科理论与实践

内科理论与实践 ›› 2025, Vol. 20 ›› Issue (01): 30-33.doi: 10.16138/j.1673-6087.2025.01.06

• 病例报告 • 上一篇    下一篇

中医药分阶段治疗非小细胞肺癌验案二则

程东峰1, 周孜奕2, 许荣忠2, 方志红2()   

  1. 1.上海交通大学医学院附属瑞金医院普外科 胰腺疾病诊疗中心 胰腺疾病研究所，上海 200025
    2.上海中医药大学附属市中医医院肿瘤科，上海 200071
  • 收稿日期:2024-03-19 出版日期:2025-02-28 发布日期:2025-04-30
  • 通讯作者: 方志红 E-mail:ffwf2001@126.com
  • 基金资助:
    上海市科学技术委员会科计计划项目(22Y11921300)

Two cases of staged treatment of non-small cell lung cancer with traditional Chinese medicine

CHENG Dongfeng1, ZHOU Ziyi2, XU Rongzhong2, FANG Zhihong2()   

  1. 1. Department of General Surgery, Pancreatic Disease Center, Research Institute of Pancreatic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
    2. Department of Oncology, Shanghai Municipal Hospital of Traditional Chinese Medicine Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200071, China
  • Received:2024-03-19 Online:2025-02-28 Published:2025-04-30
  • Contact: FANG Zhihong E-mail:ffwf2001@126.com

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摘要：

肺癌是全球发病率和死亡率最高的恶性肿瘤之一，晚期肺癌预后较差，耐药性和药物不良反应限制了临床疗效，亟需新策略。中医视肺癌为“肺积”，属“全身属虚、局部属实”，治疗强调扶正祛邪。肺癌的中医药分阶段论治分为术后扶正培本、中药联合化疗增效减毒及抗复发转移三阶段。方志红教授指出肺癌以气阴两虚为本，气滞血瘀、痰凝毒聚为标，主张辨病、辨证与辨阶段结合，强调健脾和胃，培育正气，祛除邪毒。本文通过2例非小细胞肺癌（non-small cell lung cancer, NSCLC）病例展示中医药分阶段个体化治疗的疗效。患者1（ⅢB期）经靶向治疗及化疗后予中药扶正祛邪，病灶稳定近3年，总生存期近6年；患者2（ⅡA期）术后中药辅助化疗，生存期超8年，达临床治愈。2例均以益气养阴、清热解毒、健脾化痰为法，疗效显著。

关键词: 非小细胞肺癌, 中医药, 分阶段治疗

Abstract:

Lung cancer is one of the malignant tumors with the highest incidence and mortality rates globally. The prognosis of advanced lung cancer is poor, and drug resistance and toxic side effects limit clinical efficacy on it, and new treatment strategies are urgently needed. Traditional Chinese medicine (TCM) regards lung cancer as “lung accumulation”,which belonging to “general deficiency and local excess”, and the treatment emphasizes strengthening the body and eliminating pathogens. The TCM treatment of lung cancer is divided into three phases: postoperative support and nurturing, TCM combined with chemotherapy to enhance efficacy and reduce toxicity, and prevention of recurrence and metastasis. Based on this, professor Fang Zhihong mentioned that lung cancer was fundamentally characterized as deficiency of both qi and yin, with symptoms of qi stagnation, blood stasis, phlegm coagulation and toxin accumulation. He advocated the ideas of combination of disease differentiation, syndrome differentiation, and stage differentiation during the disease treatment, emphasized strengthening the spleen and stomach, cultivate righteous qi, and eliminating evil toxins. This article presents two case studies demonstrating the effectiveness of individualized staged treatment with TCM. Case 1 (stage Ⅲ B) was treated with TCM to strengthen body and eliminate pathogens after receiving targeted therapy and chemotherapy. The lesion had been stable for nearly 3 years and a total survival time was nearly 6 years; Case 2 (stage Ⅱ A) underwent postoperative TCM-assisted chemotherapy, and the survival time exceeded 8 years, and achieved clinical cure. The therapeutic effect was significant in 2 cases after using TCM methods to tonify qi and nourish yin, clear heat and detoxify, strengthen the spleen and resolve phlegm.

Key words: Non-small cell lung cancer, Traditional Chinese medicine, Staged treatment

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