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1、遼寧中醫(yī)雜志2014年第41卷第2期·349··醫(yī)案醫(yī)話(huà)·DOI∶10.13192/j.issn.1000-1719.2014.02.064霍介格治療惡性腫瘤相關(guān)潮熱證治經(jīng)驗(yàn)舉隅12憨鑌,指導(dǎo):霍介格(1.南京中醫(yī)藥大學(xué),江蘇南京210028;2.江蘇省中西醫(yī)結(jié)合醫(yī)院,江蘇南京210028)摘要:乳腺癌及卵巢癌是婦科常見(jiàn)的惡性腫瘤,在我國(guó),乳腺癌是女性最常見(jiàn)的癌癥之一,而卵巢癌的發(fā)病率則位居?jì)D女生殖系統(tǒng)惡性腫瘤的第3位。絕經(jīng)前雌激素受體陽(yáng)性的乳腺癌患者及各期卵巢癌患者行卵巢切除術(shù)等內(nèi)分泌治療后常伴有潮熱等圍絕經(jīng)癥狀,影響其生活質(zhì)量,霍介格教授臨證多
2、以“肝腎失常”立論,從“火”入手,分陰陽(yáng),辨虛實(shí),調(diào)氣血,并著眼于臟腑之間的生克制化關(guān)系,常以疏肝泄熱,清泄肝膽實(shí)火,滋腎清肝及陰陽(yáng)雙調(diào)等法治療本病,收到了較好的效果。關(guān)鍵詞:婦科腫瘤;內(nèi)分泌治療;潮熱;辨證施治中圖分類(lèi)號(hào):R737.3文獻(xiàn)標(biāo)志碼:B文章編號(hào):1000-1719(2014)02-0349-02ProfessorJIEGehuo'sExperienceinDistinctionandTreatmentofMalignancy-RelatedHotFlush12HANBin,advsior:HUOJiege(1.NanjingUnive
3、rsityofChineseMedicine,Nanjing210028,Jiangsu,China;2.JiangsuProvincialHospitalofIntegratedChineseandWesternMedicine,Nanjing210028,Jiangsu,China)Abstract:Breastandovariancancerarethecommongynecologicalmalignancies.InChina,breastcancerisoneofthemostcommoncancersinwomenandtheinci
4、denceofovariancanceraccountsforthethirdplaceinthereproductivesystemamongwomen.Themostcommonmenopausalsymptomishotflushinthosepatientswithestrogenreceptor-positivebreastcanceraswellaseachstageofovariancancerafteroophorectomyorotherendocrinetherapy,anditalsohasalargeimpactonthei
5、rqualityoflife.Onclinic,ProfessorJIEGehuomostlymakesthepointsofliverandkidney,argumentfromthefire,distinguishingyinfromyang,deficiencyfromexcess,harmonizingqiandbloodandfocusingontherelationshipbetweenZangandFu.Thecommonprinci-plesoftreatmentaresoothinglivertopurgeheat,clearin
6、gliverandgallbladdertopurgefire,clearingliverandnourishingkidneyandregulatingyinandyang,whichhavebeenproventohaveagoodeffect.Keywords:gynecologiconcology;endocrinetherapy;hotflush;treatmentbasedonsyndromedifferentiation乳腺癌及卵巢癌是婦科常見(jiàn)腫瘤,行內(nèi)分泌治療案1董某,女,43歲,卵巢癌術(shù)后2年余,予多西(藥物或手術(shù)去勢(shì))后的患者常
7、出現(xiàn)潮熱、烘熱汗出等他賽聯(lián)合卡鉑術(shù)后輔助化療6周期,堅(jiān)持服用中藥。癥狀?;艚楦窠淌跒榻K省中西醫(yī)結(jié)合醫(yī)院主任中醫(yī)就診時(shí)訴面部烘熱陣作,易于煩躁,口干,脅脹不適,時(shí)師,師從國(guó)醫(yī)大師周仲瑛教授,從事腫瘤中西醫(yī)結(jié)合臨覺(jué)胃脘灼熱,入寐難,頭昏,耳中鳴響,納可,便干,舌苔床工作20余年,老師治療本病多本“女子以肝為先薄黃質(zhì)紅,脈弦細(xì)數(shù)。辨證屬肝胃郁熱證,以丹梔逍遙天”之旨,以肝為本,治分虛實(shí),予以疏、清、滋、溫等散化裁。藥用:丹皮10g,山梔10g,當(dāng)歸10g,白芍12法,療效較好,筆者隨師侍診,茲將老師的辨治經(jīng)驗(yàn)總g,柴胡6g,赤芍10g,生白術(shù)15g,薄
8、荷(后下)5g,生結(jié)如下。地黃15g,功勞葉15g,白花蛇舌草15g,合歡皮15g,1疏肝解郁,養(yǎng)血清熱茯神15g,甘草6