肺癌近代中醫論治文獻回顧

Modern Literature Review of Lung Cancer with Traditional Chinese Medicine

10.7102/JTCIM.202106_19(1).0001

羅勻彤(Yun-Tung Lo)；洪裕強(Yu-Chiang Hung)

肺癌 ； 中醫 ； 中藥 ； Lung cancer ； Chinese medicine ； Chinese herbs

中醫內科醫學雜誌

19卷1期（2021 / 06 / 01）

1 - 14

繁體中文

肺癌是國內多年癌症死因之首，目前西醫已發展出多種治療方式，中醫的輔助治療亦日受重視。中醫古籍雖無肺癌病名，但依其臨床表現可歸屬咯血、肺積、癥瘕積聚、肺花瘡等範疇，屬於本虛標實、虛實夾雜之證。而近代也有較多中醫文獻針對肺癌病因病機、辨證論治、醫家治療經驗進行研究與探討，雖然觀點各異，但仍可以從中歸納出共同的病機、證型與相關治則，痰瘀互結，耗氣傷陰是主要的病機，常見的證型包含氣陰兩虛、陰虛內熱、氣血瘀滯、痰瘀互結等，選方用藥在辨證基礎上臨證加減益氣滋陰、滋陰清熱、理氣活血、袪痰化瘀等治法。

Lung cancer is the leading cause of cancer mortality in Taiwan for many years. At present, modern medicine has developed a variety of treatment methods, and the adjuvant treatment of traditional Chinese medicine is also receiving increasing attention. Although there is no name for lung cancer in ancient Chinese medical books, it can be classified into certain categories according to its clinical manifestations. In terms of traditional Chinese medicine, lung cancer belongs to the syndrome of a mixture of deficiency and excess. In modern times, there are also many Chinese medical literatures on the etiology and pathogenesis of lung cancer, syndrome differentiation and treatment, and doctors' treatment experience. Although there are different opinions, common pathogenesis, syndrome types, and related treatment principles can be summarized. The main pathogenesis involves phlegm and blood stasis, consuming qi, and injuring yin. Common syndrome types include deficiency in both qi and yin, yin deficiency with internal heat, qi stagnation and blood stasis, phlegm and blood stasis, and so on. The clinical selection of prescriptions on the basis of syndrome differentiation is alterable, and the treatment principles include supplementing qi and nourishing yin, nourishing yin and clearing heat, regulating qi and promoting blood circulation, repelling phlegm and transforming stasis, etc.

1. DynaMed [Internet]. Ipswich (MA): EBSCO Information Services. 1995 - . Record No.T115654,Small Cell Lung Cancer; [updated2018 Dec 03, cited2020 Oct 17]. Available fromhttps://www.dynamed.com/topics/dmp~AN~T115654. Registration and login required.
2. Micromedex. Available at: https://www.micromedexsolutions.com/home/dispatch
3. NCCN Guidelines. Small Cell Lung Cancer (Version 1.2021-August 11, 2020). Available at: https://www.nccn.org/professionals/physician_gls/pdf/sclc.pdf
4. DynaMed [Internet]. Ipswich (MA): EBSCO Information Services. 1995 - . Record No. T114774, Non-small Cell Lung Cancer; [updated 2018 Dec 04, cited 2020 Oct 17]. Available from https://www.dynamed.com/topics/dmp~AN~T114774. Registration and login required.
5. NCCN Guidelines. Non-Small Cell Lung Cancer (Version 6.2020-June 15, 2020). Available at: https://www.nccn.org/professionals/physician_gls/pdf/nscl.pdf
6. 衛生福利部國民健康署癌症登記報告Available at: https://www.hpa.gov.tw/Pages/List.aspx?nodeid=119
7. International Agency for Research on Cancer 2018. Available at: https://gco.iarc.fr/
8. Cheng, CS,Chen, LY,Ning, ZY,Zhang, CY,Chen, H,Chen, Z(2017).Acupuncture for cancer-related fatigue in lung cancer patients: a randomized, double blind, placebo-controlled pilot trial.Support Care Cancer,25(12),3807-3814.
9. Li, TM,Yu, YH,Tsai, FJ,Cheng, CF,Wu, YC,Ho, TJ(2018).Characteristics of Chinese herbal medicine usage and its effect on survival of lung cancer patients in Taiwan.J Ethnopharmacol,213,92-100.
10. Liao, YH,Li, CI,Lin, CC,Lin, JG,Chiang, JH,Li, TC(2017).Traditional Chinese medicine as adjunctive therapy improves the long-term survival of lung cancer patients.J Cancer Res Clin Oncol,143(12),2425-2435.
11. Midthun, David E(2020).David E Midthun (2020). Overview of the risk factors, pathology, and clinical manifestations of lung cancer. In Sadhna R Vora (Ed.), UpToDate. Retrieved September 3, 2020, from https://www-uptodate-com.autorpa.cmu.edu.tw/contents/overview-of-the-risk-factors-pathology-and-clinical-manifestations-of-lung-cancer.https://www-uptodate-com.autorpa.cmu.edu.tw/contents/overview-of-the-risk-factors-pathology-and-clinical-manifestations-of-lung-cancer
12. Tang, WR,Yang, SH,Yu, CT,Wang, CC,Huang, ST,Huang, TH(2016).Long-Term Effectiveness of Combined Treatment with Traditional Chinese Medicine and Western Medicine on the Prognosis of Patients with Lung Cancer.J Altern Complement Med,22(3),212-222.
13. Thomas, Karl W,Gould, Michael K(2020).Karl W Thomas & Michael K Gould (2020). Overview of the initial evaluation, diagnosis, and staging of patients with suspected lung cancer. In Geraldine Finlay (Ed.), UpToDate. Retrieved September 3, 2020, from https://www-uptodate-com.autorpa.cmu.edu.tw/contents/overview-of-the-initial-evaluation-diagnosis-and-staging-of-patients-with-suspected-lung-cancer.https://www-uptodate-com.autorpa.cmu.edu.tw/contents/overview-of-the-initial-evaluation-diagnosis-and-staging-of-patients-with-suspected-lung-cancer
14. Yang, J,Zhu, X,Yuan, P,Liu, J,Wang, B,Wang, G(2020).Efficacy of traditional Chinese Medicine combined with chemotherapy in patients with non-small cell lung cancer (NSCLC): a meta-analysis of randomized clinical trials.Support Care Cancer,28(8),3571-3579.
15. 文贇,肖沖,祝捷,嚴然,由鳳鳴(2016)。以邪伏膜原理論為依據的肺癌辨治探討。雲南中醫中藥雜誌，37(1)，18-21。
16. 牛會琴,張小麗,田杰,朱國慶,周義浪(2019)。中晚期肺癌陰虛熱毒病機演變探析。貴陽中醫學院學報，41(1)，1-2。
17. 王保芹,李澤庚(2016)。肺癌中醫辨證分型研究進展。陝西中醫藥大學學報，39(4)，99-102。
18. 朱盼,李澤庚,董昌武(2017)。肺癌中醫證型研究概況。實用中醫內科雜誌，31(3)，91-93。
19. 吳繼,劉嘉湘(2012)。劉嘉湘扶正治療肺癌用藥經驗。遼寧中醫雜誌，39(4)，617-619。
20. 季興祖,周敏華,李權,杜單瑜,劉笑靜(2017)。吳玉生教授治療肺癌經驗介紹。浙江中醫藥大學學報，41(8)，699-701。
21. 金路,王志英(2016)。國醫大師周仲瑛從痰瘀郁毒辨治肺癌癌性疼痛。中醫學報，31(11)，1637-1639。
22. 柯獻欽,鄭高珍(2018)。晚期非小細胞肺癌之化學治療與標靶治療。內科學誌，29，143-152。
23. 孫牧,牛春風,旋静(2019)。晚期非小细胞肺癌病機初探。世界最新醫学信息文摘，19(65)，219-220。
24. 徐升,徐經世(2018)。國醫大師徐經世治療肺癌學術經驗。山東中醫雜誌，37(4)，319-321。
25. 張文曦,劉苓霜,朱欣佚(2020)。國醫大師劉嘉湘從顧護脾胃論治肺癌經驗。南京中醫藥大學學報，36(4)，557-560。
26. 張怡,王笑民(2013)。肺癌病機證候研究概況。中華中醫藥雜誌，28(11)，3325-3328。
27. 張星星,李澤庚(2015)。肺癌中醫病因病機探討。中華中醫藥雜誌，30(10)，3447-3449。
28. 張博,李雁。肺癌可從胸痹論治。遼寧中醫雜誌
29. 郭建輝,王志英(2012)。周仲瑛從癌毒論治肺癌學術思想舉要。遼寧中醫雜志，39(3)，410-411。
30. 單紅梅,奚肇慶(2020)。奚肇慶固本求源法辨治肺癌。中醫藥臨床雜志，32(1)，13-15。
31. 馮解語,羅斌,董昌盛,衣秀秀,錢芳芳,田建輝(2017)。田建輝治療肺癌轉移的用藥規律。湖北中醫藥大學學報，19(3)，101-106。
32. 賈丹,王文萍(2019)。淺析原發性肺癌患者中醫證型分佈規律。山西中醫，35(11)，48-50。
33. 劉偉,張虹,郝正華(2016)。肺癌的中醫藥古代文獻研究。湖南中醫雜誌，32(12)，136-137。
34. 蔡云,陳遠彬,葉放,吳蕾,李柳,林琳(2020)。國醫大師周仲瑛從癌毒理論辨治肺癌經驗述要。中華中醫藥雜誌，35(6)，2879-2882。
35. 衛生福利部統計處 Available at: https://dep.mohw.gov.tw/DOS/lp-1720-113-3-20.html?fbclid=IwAR0kquGZ-OucSEHM0r-Rd2fo7EG-8fKPyqhVZJcrwK7Y6qPPFNRPpwu7Frs
36. 謝長生,王東建,潘磊,陳培豐(2010)。561例肺癌中醫證型與 TNM 分期及病理類型的相關性探索。浙江中醫雜誌，45(6)，398-399。