本文選題：戰(zhàn)麗彬　切入點(diǎn)：學(xué)術(shù)思想　出處：《大連醫(yī)科大學(xué)》2016年碩士論文

【摘要】：目的:本研究通過系統(tǒng)收集、整理戰(zhàn)麗彬教授2014年至2015年門診診治的癌因性疲乏患者的病案,分析典型病案,總結(jié)導(dǎo)師的學(xué)術(shù)思想、臨床經(jīng)驗(yàn)、用藥規(guī)律與特色,傳承與弘揚(yáng)中醫(yī)學(xué)術(shù)思想,為臨床治療癌因性疲乏提供參考與指導(dǎo)。方法:本研究分為兩部分:第一部分,通過研讀中醫(yī)經(jīng)典古籍和現(xiàn)代文獻(xiàn)研究,臨床侍診和導(dǎo)師傳授,整理、分析、總結(jié)出導(dǎo)師在治療癌因性疲乏方面的學(xué)術(shù)思想;第二部分,通過系統(tǒng)收集戰(zhàn)麗彬教授2014年至2015年門診診治的惡性腫瘤患者的病案,整理存在癌因性疲乏的患者的病案,進(jìn)行分類、歸納,計(jì)算出癌因性疲乏的發(fā)病率,研究其處方用藥的規(guī)律與特色,詳細(xì)分析三例臨床典型病案,分析導(dǎo)師對(duì)甲狀腺癌、肺癌、宮頸癌患者的癌因性疲乏的辨證論治及遣方用藥,總結(jié)導(dǎo)師治療癌因性疲乏的臨床經(jīng)驗(yàn)。結(jié)果:第一部分,總結(jié)出導(dǎo)師在治療腫瘤患者的癌因性疲乏方面的五大學(xué)術(shù)思想,即“研讀經(jīng)典、精于臨床”,“虛則補(bǔ)之、損者益之”,“屢攻屢補(bǔ)、以平為期”,“尤重脾陰、從脾論治”,“善調(diào)情志、改善睡眠”。第二部分,收集的58例惡性腫瘤患者中,存在癌因性疲乏的患者有38例,發(fā)病率為66%。研究分析這38例患者的病案,并結(jié)合詳細(xì)分析導(dǎo)師對(duì)甲狀腺癌、肺癌、宮頸癌患者的癌因性疲乏這三例臨床典型病案的辨證論治與遣方用藥,總結(jié)出導(dǎo)師在治療腫瘤患者的癌因性疲乏方面的臨床經(jīng)驗(yàn),導(dǎo)師善用生黃芪、黨參、白術(shù)、茯苓、炙甘草,恰是化裁于有著“天下補(bǔ)氣第一名方”之美譽(yù)的四君子湯,其中生黃芪、黨參,白術(shù)、茯苓,是導(dǎo)師臨床常用的兩個(gè)核心藥對(duì),諸方配伍炙甘草,處方時(shí)以四君子湯為基礎(chǔ),另重用生黃芪,根據(jù)正虛的程度、疲乏的程度、各癥狀的緩急以及與癌因性疲乏的關(guān)系,處方用藥隨癥加減。導(dǎo)師還擅用白花蛇舌草、半枝蓮、半邊蓮、山慈菇這一清熱解毒抗腫瘤的藥物組合。此外,導(dǎo)師重視情志的調(diào)理和睡眠的改善對(duì)治療癌因性疲乏的重要性,常用陳皮、清半夏這一藥對(duì)疏理氣機(jī)、調(diào)暢情志,生龍骨和生牡蠣這一藥對(duì)改善睡眠。其用藥規(guī)律具有四大特色,即“補(bǔ)氣健脾以扶正”、“清熱解毒抗腫瘤”、“疏理氣機(jī)調(diào)情志”、“重鎮(zhèn)安神助睡眠”,此與第一部分相呼應(yīng)。結(jié)論:導(dǎo)師重視中醫(yī)經(jīng)典,精于臨床實(shí)踐,對(duì)中醫(yī)虛勞的經(jīng)典理論有著深刻且獨(dú)到的見解;對(duì)癌因性疲乏的臨床治療有著豐富且獨(dú)特的臨床經(jīng)驗(yàn)及診療風(fēng)格。導(dǎo)師重視辨病與辨證相結(jié)合,傳統(tǒng)中醫(yī)藥與現(xiàn)代藥理學(xué)研究相結(jié)合,中西醫(yī)學(xué)各自的優(yōu)勢(shì)和特長(zhǎng)相結(jié)合,應(yīng)用于臨床,獲得顯著療效。
[Abstract]:Objective: through systematic collection, this study collated the medical records of cancer related fatigue patients diagnosed and treated by Professor Zhan Libin from 2014 to 2015, analyzed the typical cases, summed up the academic thoughts, clinical experiences, drug use rules and characteristics of the tutor. Methods: this study is divided into two parts: the first part, through the study of traditional Chinese medicine classical books and modern literature research, clinical consultation and mentor teaching, Sorting out, analyzing and summarizing the academic thoughts of the tutor in the treatment of cancer-related fatigue. Part two, through systematically collecting the medical records of malignant tumor patients diagnosed and treated by Professor Zhan Libin in the outpatient clinic from 2014 to 2015. Sorting out the medical records of patients with cancer-induced fatigue, classifying, summing up, calculating the incidence of cancer-induced fatigue, studying the law and characteristics of prescribing drugs, analyzing in detail three clinical typical cases, analyzing mentors' views on thyroid cancer and lung cancer. Diagnosis and treatment of cancer-induced fatigue in patients with cervical cancer and prescription, the clinical experience of tutor in treating cancer-induced fatigue was summarized. Results: in the first part, five major academic thoughts of tutor in the treatment of cancer-related fatigue of cancer patients were summarized. That is, "to study the classics, to be good at clinical practice," "to make up for the deficiency, to benefit the injured", to "repeatedly attack and compensate for the same period of time", "to pay special attention to the spleen yin, to treat the spleen from the spleen", "to adjust emotions and improve sleep". Part two, of the 58 patients with malignant tumors collected, There are 38 patients with cancer-related fatigue, with an incidence of 66.The study analyzed the medical records of these 38 patients, and combined with detailed analysis of mentors for thyroid cancer, lung cancer, Cancer related fatigue of cervical cancer patients: differentiation and treatment of three typical clinical cases and prescriptions, summing up the clinical experience of tutor in the treatment of cancer-induced fatigue of cancer patients, tutors to make good use of Astragalus membranaceus, Codonopsis, Atractylodes macrocephala, Poria cocos, Grilled licorice is precisely a four-gentleman soup with the reputation of "replenishing qi first in the world". Among them, Astragalus, Codonopsis, Atractylodes macrocephala, Poria cocos, are the two core drug pairs commonly used by mentors in clinical practice. The prescription is based on the Sijunzi decoction and reused the raw astragalus. According to the degree of deficiency, the degree of fatigue, the priority of symptoms and the relationship between the symptoms and cancer-related fatigue, the prescription medicine is added or subtracted with the symptoms. The tutor is also good at using Scutellaria chinensis and Scutellaria Scutellariae. In addition, tutors attach importance to the importance of emotional conditioning and sleep improvement in the treatment of cancer-related fatigue. Raw keels and oysters are drugs that improve sleep. They have four characteristics. That is, "tonifying qi and invigorating spleen", "clearing away heat and detoxifying and anti-tumor", "soothing qi and regulating mood", and "focusing on the town to calm the mind and help sleep", which echo the first part. Conclusion: the tutor attaches importance to the classic of traditional Chinese medicine and is good at clinical practice. He has profound and unique views on the classical theory of asthenia and fatigue in traditional Chinese medicine, and has rich and unique clinical experience and diagnosis and treatment style in the treatment of cancer-related fatigue. The tutor attaches importance to the combination of disease differentiation and syndrome differentiation. The combination of traditional Chinese medicine and modern pharmacology, and the combination of Chinese and western medicine with their own advantages and specialties, has been applied to clinical practice and achieved remarkable curative effect.
【學(xué)位授予單位】：大連醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2016
【分類號(hào)】：R249;R273

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