口咽癌相关口咽干燥症“分期论治”思路探析

Analysis on the idea of “staging treatment” of oropharyngeal carcinoma-related xerostomia

关键词:  口咽癌  口咽干燥症  分期论治  思路

Key words:  oropharyngeal carcinoma  xerostomia  treatment by stages  train of thought

摘要:

口咽癌作为头颈部恶性肿瘤， 病势凶险、病位特殊， 放射性疗法临床获益明显， 但易损伤口咽部黏膜及腺体造成口咽干燥症， 由此不仅影响患者生活质量也阻碍治疗进程。故口咽干燥症病机： 先有正气亏虚、癌毒内生、蕴结弥漫阻滞于口咽经络， 后有热毒侵袭、伤津耗气、伏邪内藏以致脉络枯萎。因此以“三焦辨证”法为基础， 通过分期论治达到明确病程分期、辨析疾病病机、灵活用药、燥湿相济、攻补兼施、升降相宜， 其疗效颇佳。现将临证辨治思路及用药特点总结如下， 并结合案例进一步分析， 以兹借鉴。

Abstract:

As one of the malignant tumors of the head and neck，oropharyngeal carcinoma has a dangerous condition and special position， and its clinical benefit from radiotherapy is obvious，but its easily damaged pharyngeal mucosa and glands cause xerostomia，which not only affects the life quality of the patients，but also further hinders the progress of treatment. Therefore，the pathogenesis of xerostomia as following：first，there are deficiency of vital qi，endogenesis of cancer toxin，diffuse blockage of oropharynx meridians，followed by heat toxin invasion，injury and consumption of qi，hidden evil and so that the veins wither. Based on the method of “Sanjiao syndrome differentiation”，the curative effect is quite good through staging，differentiation and analysis of the pathogenesis of the disease，flexible use of drugs，combination of dryness and dampness，attack and tonic，and appropriate rise and fall. Now the ideas of clinical differential treatment and the characteristics of drug use are summarized as follows，and combined with the case for further analysis，in order to draw lessons from.