中医补法治疗前列腺癌研究进展

Research progress on tonifying therapy of traditional Chinese medicine for prostate cancer

关键词:  前列腺癌  中医治疗  补法

Key words:  prostate cancer  traditional Chinese medicine treatment  tonifying therapy

摘要:

中医在治疗前列腺癌临床辨治中补法地位重要。中医药应用补法治疗前列腺癌重点施补脏腑各有不同，学界对健脾、补肾最为重视。脾虚病机大多均为脾阳虚或脾气虚不能运化，治以补气、温阳、健脾之法，避免滋腻、峻猛之药，兼以行气、利湿；前列腺癌肾虚病机较为复杂，需辨明阴阳，考虑补肾药滋腻的特性及部分补肾药的雄激素样作用对肿瘤病灶的影响。针对疾病进展的不同阶段侧重点也有不同，根治术术后阶段，以补益气血为主，配伍收涩药物；内分泌治疗阶段以益气生津，滋阴润燥为主；放化疗期应补充真阴真阳，并通过健脾利湿、补气生血、益肾保骨以缓解抗肿瘤治疗不良反应；去势抵抗阶段，应更注重整体调节，活用健脾、补肾、益气、补血诸法。

Abstract:

Traditional Chinese medicine often employs tonifying methods in the clinical treatment of prostate cancer. The application of tonifying methods in the treatment of prostate cancer varies according to the differentiation of syndrome patterns and disease progression stages. Spleen and kidney are highlighted as key organs. The pathogenesis of Spleen deficiency is mainly characterized by spleen yang deficiency or spleen qi deficiency with impaired transformation. Treatment strategies should focus on tonifying qi，warming yang，invigorating the spleen，promoting qi circulation and dampness elimination，and avoiding overly nourishing and strong-tonifying herbs. The pathogenesis of kidney deficiency requires differentiation of yin and yang. Consideration should be given to the potentially testosterone-like effects of certain kidney-tonifying herbs on tumor lesions. Prostate cancer can be categorized into four stages： Post-radical prostatectomy stage requires replenishing qi and blood while incorporating astringent herbs. Endocrine therapy stage primarily focuses on reinforcing qi，generating fluids，and nourishing yin. During the radiotherapy/chemotherapy stage，it is essential to supplement both true yin and true yang，mitigate adverse reactions to anti-tumor treatments by invigorating the spleen and promoting dampness elimination，and tonify qi and nourish blood. In the castration-resistant stage，a holistic approach is recommended，combining tonification of the spleen，kidney，qi，and blood.