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袁博,范洪桥,刘丽芳.刘丽芳教授从络病理论辨治乳腺癌相关淋巴水肿的经验[J].湖南中医药大学学报,2023,43(11):2008-2012[点击复制] |
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| 刘丽芳教授从络病理论辨治乳腺癌相关淋巴水肿的经验 |
| 袁博,范洪桥,刘丽芳 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007) |
| 摘要: |
| 乳腺癌相关淋巴水肿是乳腺癌术后最常见的并发症,其成因与手术破坏局部淋巴管导致局部微循环障碍、微血管失调、神经损伤等导致淋巴回流受阻有关。刘丽芳教授基于现代研究对乳腺癌相关淋巴水肿的认识,结合其临床表现,认为乳腺癌相关淋巴水肿可从中医学的"络病"视角进行论治。认为乳腺癌相关淋巴水肿的病因病机为金刃损伤络脉,耗伤气血以致络脉虚损,日久成积。络脉不通是乳腺癌相关淋巴水肿形成的核心病理环节。治疗上遵"络脉以通为用"之旨,将通络之法贯穿治疗全程,并灵活运用养络充络、祛瘀通络、剔邪搜络之法治疗乳腺癌相关淋巴水肿,常使用圣愈汤合三甲复脉汤、补阳还五汤、国医大师熊继柏经验方黄芪虫藤饮加减治疗,以收行气通络、开闭消肿之效,在临床上取得了良好的疗效。附临床验案,以期为临床治疗该病提供新思路和参考。 |
| 关键词: 乳腺癌 淋巴水肿 络病 刘丽芳 名医经验 养络充络 祛瘀通络 剔邪搜络 熊继柏 黄芪虫藤饮 |
| DOI：10.3969/j.issn.1674-070X.2023.11.012 |
| 投稿时间：2023-06-20 |
| 基金项目:国家自然科学基金项目（82205128）；长沙市自然科学基金项目（kq202461）；国家中医药管理局第七批全国老中医专家学术经验继承项目（国中医人教发〔2022〕76号）；湖南省卫生健康委员会科研课题项目（D202304136382）。 |
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| Professor LIU Lifang's experience in differentiating and treating breast cancer-related lymphedema based on collateral disease theory |
| YUAN Bo,FAN Hongqiao,LIU Lifang |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China) |
| Abstract: |
| Breast cancer-related lymphedema (BCRL) is the most common complication after breast cancer surgery, which results from the obstruction of lymphatic return due to local microcirculation disturbance, microvascular disorders, and neurological damage caused by surgical injury. Based on the modern understanding of BCRL, combined with its clinical manifestations, Professor LIU Lifang believes that BCRL can be differentiated and treated from the perspective of TCM collateral disease theory. Moreover, she believes that the knife (scalpel) injuring collaterals leads to the consumption of qi and blood, thus causing impairment of collaterals which are in charge of the distribution of blood and body fluids, hence resulting in pathological accumulation of them. Collaterals obstruction is the core pathological process that results in the formation of BCRL. Therefore, when treating BCRL, Professor LIU follows the principle of "the collaterals should be unblocked to function well", and makes it run through the whole process of treatment, with flexible use of nourishing and filling collaterals, transforming stasis and unblocking collaterals, and searching collaterals and eliminating pathogenic factors. And, Shengyu Decoction combined with Sanjia Fumai Decoction, Buyang Huanwu Decoction, and National TCM Master XIONG Jibai's empirical formula, namely Modified Huangqi Chongteng Drink, is commonly used to promote qi circulation, unblock collaterals, and reslove swelling, which has achieved good curative effects in clinic. In addition, clinical medical records are attached, so as to provide new ideas and references for clinical treatment of the disease. |
| Key words: breast cancer lymphedema collateral disease LIU Lifang experience of famous doctors nourishing and filling collaterals transforming stasis and unblocking collaterals searching collaterals and eliminating pathogenic factors XIONG Jibai Huangqi Chongteng Drink |
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