| 引用本文: |
张根明, 杨莹, 蒋伶俐, 李珂, 毛启远, 林洪生, 李道睿.从络病理论探讨骨肉瘤巩固治疗阶段的辨治规律[J].湖南中医药大学学报,2026,46(5):987-992[点击复制] |
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| 从络病理论探讨骨肉瘤巩固治疗阶段的辨治规律 |
| 张根明,杨莹,蒋伶俐,李珂,毛启远,林洪生,李道睿 |
| (北京中医药大学, 北京 100700;中国中医科学院广安门医院, 北京 100053;中国医学科学院肿瘤医院, 北京 100021) |
| 摘要: |
| 骨肉瘤（OS）是一种高度恶性的原发性骨肿瘤，易转移与复发，严重影响患者预后。中医药在OS综合治疗中具有独特优势，尤其在防止复发转移的巩固治疗阶段，其干预价值尤为突出。本文结合络病理论与林洪生教授“固本清源”学术思想，探讨OS巩固治疗阶段的中医辨治规律。OS患者经手术与放化疗后，其络病病机特征发生转变，核心病机演变为“正虚络空、余毒伏留”。治法上强调“补虚充络”（益气养阴）以固本，“通络祛邪”（行气活血、清热解毒、化痰散结）以清源，二者协同应用，以期改善机体局部微环境，截断伏邪流窜传变。并附验案一则以证其效。 |
| 关键词: 骨肉瘤|络病理论|巩固治疗阶段|五治五养|固本清源|辨治规律|肿瘤微环境|林洪生 |
| DOI：10.3969/j.issn.1674-070X.2026.05.016 |
| 投稿时间：2025-12-12 |
| 基金项目:国家自然科学基金项目（82074405）；癌症、心脑血管、呼吸和代谢性疾病防治研究国家科技重大专项（2024ZD0521303）；北京中医药大学教育科学研究课题（XJZ25046）。 |
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| Pattern differentiation and treatment rules for osteosarcoma in the consolidation therapy stage based on the collateral disease theory |
| ZHANG Genming, YANG Ying, JIANG Lingli, LI Ke, MAO Qiyuan, LIN Hongsheng, LI Daorui |
| (Beijing University of Chinese Medicine, Beijing 100700, China;Guang'anmen Hospital of China Academy of Chinese Medical Sciences, Beijing 100053, China;Cancer Hospital of Chinese Academy of Medical Sciences, Beijing 100021, China) |
| Abstract: |
| Osteosarcoma (OS) is a highly malignant primary bone tumor characterized by a high propensity for metastasis and recurrence, which severely compromises patient prognosis. Chinese medicine has unique advantages in the comprehensive management of OS, particularly during the consolidation therapy stage aimed at preventing recurrence and metastasis, where its interventional value is especially prominent. This article combines the collateral disease theory with Professor LIN Hongsheng's academic thought of "consolidating the root and clearing the source" to explore the TCM pattern differentiation and treatment rules for OS during the consolidation therapy stage. Following surgery, radiotherapy, and chemotherapy, the collateral disease-based pathogenesis in OS patients undergoes a transformation, with the core pathogenesis evolving into "healthy qi deficiency and collateral emptiness with latent residual toxin." The therapeutic approach emphasizes "tonifying deficiency to replenish the collaterals" (supplementing qi and nourishing yin) to consolidate the root, and "unblocking the collaterals and eliminating pathogens" (circulating qi and blood, clearing heat and removing toxins, resolving phlegm and dissipating masses) to clear the source. These two strategies are applied synergistically to improve the local microenvironment and interrupt the spread and transformation of latent pathogens. A verified medical record is provided to demonstrate the efficacy. |
| Key words: osteosarcoma|collateral disease theory|consolidation therapy stage|five treatments and five nurtures|consolidating the root and clearing the source|pattern differentiation and treatment rules|tumor microenvironment|LIN Hongsheng |
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