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| 临床研究 |
Clinical Research of Leukemia |
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白血病临床研究
一: 对白血病的独到见解
在长期的理论学习和临床实践中,温大夫发现西医治疗白血病存在着很多弊端,于是他把主攻的目标转向了中医.他把自己几十年来收集到的秘方,验方和古方,经过吸取精华,剔除糟粕,去伪存真的选择,并结合自己的实践经验,又运用现代中医学最新成果,对白血病的病因及病理总结出了自己独特,新颖的观点;白血病病因乃由于机体正气不足,易受毒邪侵袭,由表入里,正虚邪盛,阴精受损,骨热熏蒸,热伤血脉,迫血妄行或久病气血双亏,导致血症,上溢而见鼻衄,齿衄,咯血呕血,下溢而见便血,尿血,妇女则崩漏不止,若溢于肌肤粘膜可见紫癜.由于正虚或受外邪和阴伤血败,营血热炽,高热持久不退.病程稍久,气血更亏,气滞血淤,脉络阻塞,结于肋下形成淤块.视病态发展,若毒邪由盛而衰,正气渐复,可得以缓解;若毒邪未尽,则经常反复,邪衰正虚,可导致气血两亏.综上所述,白血病的病因病理较为复杂,所以虚为主,因虚致病,但亦有因病致虚的病机演变,所以有虚有实,虚非纯虚,实非纯实,基本上是以本虚标实之症;以虚为主的一种疾病.
从白血病的病情发展来看,一般可分为如下三大征候:
1. 发热
若寒战,高热,头痛,骨节酸疼,烦躁,口干舌燥等是实症,如日晡潮热,五心烦热,形体消瘦,乏力等均属阴虚内热之象.
2. 出血:
出血其有虚实之分,患者可因体虚气焰或久病耗伤气血统摄无权,或阴虚火旺, 迫血妄行而出血,实者由于阴虚热盛或热毒内焰伤及脉络而迫血妄行,溢于脉外,此多见于皮肤淤斑或齿衄,鼻衄等症.
3. 贫血
由于热伤营阴,精髓受损则生血不足,如有出血者,则更加重了贫血.
二: 对白血病的科学治则
温大夫认为,在治癌诸法中最霸道伤身的化疗,即以“全部杀死”法为主要治疗手段,不能彻底治愈白血病,今后的治疗方式应该彻底改变,即主要依靠设法保护和提高人体本身的“免疫功能”和“自疗功能”,来解决自身的矛盾,换言之,即遵循生命的本能,在提高自身调解功能的基础上,达到治愈之目的.
具体来讲,在中医治疗白血病方面应遵守如下无五大治疗法则:
1: 四诊八纲,辨证施治.
白血病存在着一个共同特性,就是肾阴亏,相火旺,蕴毒深,血液伤,冲任失调.医治大法是补肾阴,泻相火,解蕴毒,调冲任,补血换髓.其中,补肾阴就是扩大体液和细胞生化的资源,并加强其静止状态,从而延长骨髓和血液的生存期.泻相火,即减低细胞周期运动的速率,亦即缓解其增生与代谢,供以减少其对骨髓和血液的消耗,补肾和泻相火使机体的周期运动.恢复正常,则白细胞的增生受到抑制,幼稚细胞得以转化,其他血象亦以维持其平衡.解蕴毒,治疗蕴毒的法则有三:透发托毒,为蕴毒找出路,也即趋表外出.清热解毒,由于白血病患者多气血两亏,
蕴毒陷状不易透发,则可用清热解毒法内消;扶正化毒,即提高免疫力以转化和抑制蕴毒.调冲任, 冲任脉为血海,汇通五脏,任脉沉静蛰藏,主一身之阴,加强冲任功能,可以调节血液之生化周期,缓和增生,补血换髓,补血是治标,输血亦是治标的应急.近代医学有以换血之法治之,即放出患者之血,输以健全的血,此种疗法实属徒劳.因血之再生有赖于髓,而白血病的病源却在于髓,故根治之法应换髓.中医学认为肾主骨,骨生髓,以补肾,解毒,经过一个时期的新陈代谢,这就是逐步的换髓法.
2. 白血病的参考麻疹和痘疮之病因治则.
因麻疹和痘疮都是机体托毒外出的一种症候,其辨证施治的触类旁通,极有参考价值.
3. 参考温病, 正虚, 血症, 骨蒸等症之病因治则.
温病之高热,正虚之萎黄贫血,小儿之疳积,血症之出血及大衄,骨蒸之潮热消瘦,皆有和白血病类同之一面,故这些疾病的理法,方药亦可治疗白血病的重要参考.
4. 参考“类白血病”和“白血病”只是病原的部位和深浅所不同,故亦可参考之.
5. 免疫疗法的运用.
新兴的免疫疗法,对于白血病,尤其是“急白”有一定的疗效,此种疗法是属于中医的”扶正祛邪”疗法的范畴.
温大夫认为,白血病的病根较深,在治疗上较为复杂困难.但是,绝不能把难治之症即“癌”症,更不应该有“癌”是治不好的,
治好的不是”癌”的错误心理.治病必须治其本,我们必须破除白血病是“癌”之说,跳出现代医学体系的治疗方案,在尊重”宿主”,支援生理自疗功能的基础上,探寻出正确有效的治疗法则.
Clinical Research of Leukemia
I. Original View of Leukemia
In long-term theory study and clinical practice, Doctor Wen found that the Western Medicine still has some defects in treatment of leukemia and turned his main research to the traditional Chinese medicine. He collected large amount of nostrum, proved recipe and ancient prescription in a few decades, and he discarded the dross and assimilated the essence as well as eliminated the false and retained the true and at last made selection and summary; in combination with his own practical experience as well as applying the latest achievements of modern traditional Chinese medicine, he summarized the unique and novel views of pathogeny and pathology of leukemia. The pathogeny of leukemia is: the deficiency of vital qi makes the body easy to suffer epidemic toxin invasion from the superficies to interior. Deficiency of vital qi and excess of pathogen qi, deficiency of yin essence, bone heat and fumigation and steaming, heat injuring blood and vessels, hyperactivity of blood, or deficiency of qi and blood caused by prolonged illness, which lead to the blood syndrome. Overflow could cause epistaxis, gum bleeding, hemoptysis and hematemesis, underflow could cause hemafecia, hematuria, and as for the women, there would be metrorrhagia. In case of flowing to skin, there would be purpura on the mucosa. The deficiency of vital qi or the vital qi invaded by external pathogen qi, injury of yin and deficiency of blood, as well as exuberant heat nutrient-blood cause the persistent high fever. If the disease is prolonged, the deficiency of qi and blood is worsened, thus the qi-stagnation and blood stasis are caused and then the arteries and veins are blocked, which accumulate in the subcostal part and forms the stasis. If the toxicity and pathogenic qi fall and vital qi recover gradually, the disease could be alleviated basing on the development of disease conditions; if the toxicity and pathogenic qi are not removed completely and reoccur frequently, the vital qi is deficient and pathogen qi is excessive, the deficiency of qi and blood could be caused. To sum up, pathogeny and pathology of leukemia are complicated. Therefore, the deficiency is dominant, which leads to the disease. However, pathogenesis evolution that the disease leads to deficiency also exists. Thus both deficiency and excess exist, as well as deficiency is not pure deficiency and excess is not pure excess. The leukemia is basically the syndrome that has deficient root cause and excessive manifestation; and is the disease with the main symptom of deficiency.
From the status development of leukemia, there are generally three symptoms as follows:
1. Fever
The shivering, high fever, headache, sour pain of joint, dysphoria and dry mouth and tongue are excessive syndromes. The afternoon tidal fever, dysphoria with feverish sensation in chest, palms and soles, emaciation and weakness are yin deficiency and endogenous heat syndromes.
2. Hemorrhage
The hemorrhage is different in deficiency and excess. The patient may hemorrhage due to hyperactivity of blood because of weakness, excess of qi or deficiency of qi and blood caused by prolonged illness, failure in controlling, or hyperactivity of fire due to deficiency of yin. As for the excess, deficiency of yin and intense heat or heat-toxin damaging arteries and veins causes hyperactivity of blood and hemorrhage, which is usually shown as the ecchymosis on the skin or gum bleeding and epistaxis.
3. Anemia
Production of blood is deficient because of nutrient qi and yin fluid being injured by heat, marrow and essence being damaged. In case of hemorrhage, the anemia would be worsened.
II. Scientific Treatment Principle of Leukemia
Doctor Wen believes that the chemotherapy is the most potent treatment method and causes most injuries to the health, i.e. “killing all” is the main treatment method, which could not cure the leukemia thoroughly. The future treatment method should be changed, that is, solving its own contradictions by trying to protect and improve the “immunity function” and “self-healing function,” i.e. abiding by the life instinct to achieve the goal of curing disease on basis of improving self-regulating function.
Specifically, the following five rules shall be followed when treating leukemia by traditional Chinese medicine:
1. Four Diagnostic Methods and Eight Principles, Dialectic Treatment
The general character of leukemia is deficiency of kidney yin, hyperactivity of fire, toxicity accumulated deeply, blood being injured, disharmony of Chong and Conception Channels. The treatment method is to nourish kidney yin, clear ministerial fire, remove accumulated toxicity, harmonize Chong and Conception Channels, and replenish blood and replace marrow. Nourishing kidney yin is to enlarge the resources of body fluid and cell biochemistry and strengthen its static status so as to prolong existence period of marrow and blood. Clearing ministerial fire is to reduce the speed of periodic motion of cells, and that is also to slow down their hyperplasia and metabolism so as to reduce their consumption of marrow and blood. Nourishing kidney and clearing ministerial fire aim at normalizing the periodic motion of organism so that hyperplasia of leucocyte is inhibited and the immature cells could be transformed, other blood manifestation is also kept balance. The three rules for removing and treating accumulated toxicity: promoting eruption and expelling toxicity, finding ways for removing accumulated toxicity, i.e. expelling toxicity by getting through superficies. As for clearing heat-toxicity, because most of the leukemia patients suffering deficiency of qi and blood, the accumulated toxicity invades interiorly and difficult to erupt, so the method of clearing heat-toxicity could be used for interior elimination; strengthening body resistance and removing toxicity are to improve immunity so as to transform and inhibit accumulated toxicity. As for harmonizing Chong and Conception Channels, Chong and Conception Channels are bloodbath and connect with the five zang viscera. The Conception Channels are silent and storing and governing the yin qi of the whole body. Strengthening functions of Chong and Conception Channels could regulate the biochemical period of blood, slow down the hyperplasia, and replenish blood and replacing marrow. Replenishing blood is the symptomatic treatment and blood transfusion is the emergency method of symptomatic treatment. In modern medicine, the method of exchange transfusion is used to treat the disease, i.e. doing phlebotomy on the patient and transfuse healthy blood, which is in vain. Because the regeneration of blood depends on marrow, while the pathogeny of leukemia is marrow, so the radical treatment is to exchange the marrow. The traditional Chinese medicine thinks that kidney governs bones, bones produce marrow to nourish kidney and remove toxicity, and there is a period of metabolism, which is progressive method of exchange marrow.
2. Pathogeny and treatment principle of leukemia referring to those of measles and smallpox
For the measles and smallpox are symptoms of expelling toxicity, their dialectic treatment could be comprehended by analogy and have great value of reference.
3. Referring the pathogeny and treatment principle of epidemic febrile disease, deficiency of vital qi, blood syndrome and bone steaming
High fever of epidemic febrile disease, sallow complexion and anemia of deficiency of vital qi, infantile malnutrition, hemorrhage and bleeding of blood syndrome, as well as tidal fever and emaciation of bone steaming are all similar to leukemia. Therefore, principle-method-recipe-medicines of these diseases could also be important reference for treatment of leukemia.
4. The “leukemoid disease” is only different from leukemia in part and depth of pathogeny, thus it could be referred.
5. Application of Immunotherapy
The emerging immunotherapy has certain effects on leukemia, especially “acute leukemia,” such treatment belongs to the treatment of “strengthening vital qi to eliminate pathogenic factor” in traditional Chinese medicine.
Doctor Wen believes that the root cause of trouble of leukemia is deep and it is difficult and complicated to treat. However, the difficult diseases shall not be equal to the cancer, and anyone shall not have wrong thought that the cancer could not be cured and the disease that could be cured is not “cancer.” Treating disease shall treat the root cause of disease and we must get rid of the statement that the leukemia is cancer, step out of the limit of therapeutic schedule of modern medicine, and explore the right and effective treatment principles basing on respecting host and supporting physiological self-healing.
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