林胜友教授治疗肿瘤放化疗后不寐经验

目的]总结林胜友教授治疗肿瘤放化疗后不寐的临床经验。方法]通过随师临证,记录、分析整理林胜友教授治疗肿瘤放化疗后不寐的临床病案,从病因病机、辨证论治及用药特点等方面总结林胜友教授的临床经验,并列举验案加以佐证。结果]林胜友教授认为,肿瘤患者放化疗后以正气虚弱为基础,热毒、药毒导致阴阳失衡、痰瘀互结而致心神不宁,夜寐不安。临证可分为阴虚火旺、脾虚湿阻、脾肾两虚、肝郁脾虚4大证型。治疗上强调"补其不足,泻其有余,调其虚实"的用药方法,同时合理运用健脾、益气、补肾等中药整体改善肿瘤患者放化疗后脾气亏虚、肾气不充的证候,整体调护,夜寐得安。验案中患者胃癌术后,加之长期化疗,导致脾胃气虚、心神失养,以补气健脾、养血安神为主要治法,疗效确切。验案精准辨治,充分体现了林胜友教授治疗肿瘤放化疗后不寐的临床经验。结论]林胜友教授治疗肿瘤放化疗后不寐注重整体阴阳的调节,强调分清虚实正邪的关系,以"补其不足,泻其有余,调其虚实"为治则,重视补脾益肾,整体调护,临床疗效显著,值得借鉴。

Professor LIN Shengyou's Experience in Treating Insomnia in Cancer Patients after Radiotherapy and Chemotherapy

Objective] To summarize Professor LIN Shengyou''s clinical experience in the treatment of insomnia in cancer patients after radiotherapy and chemotherapy. Methods] Through following teacher in clinical work, analyzing and sorting out the clinical cases, the clinical experience of Professor LIN Shengyou in the treatment of insomnia in cancer patients after radiotherapy and chemotherapy was summarized from the aspects of etiology and pathogenesis, syndrome differentiation and medication characteristics.Besides,a clinical case was cited as proof. Results] Professor LIN Shengyou believes that the pathogenesis of insomnia is based on the weakness of vital energy. Heat toxicity and drug toxicity leads to the imbalance between Yin and Yang, phlegm and blood stasis, results in restlessness at night.The clinical syndromes can be divided into four types: Yin deficiency and fire prosperity, spleen deficiency and dampness obstruction, spleen and kidney deficiency, liver depression and spleen deficiency.In clinical practice, therapeutic methods of reinforcing deficiency, reducing surplus and regulating deficiency and excess are emphasized.At the same time, traditional Chinese medicine should be adopted to invigorate spleen, tonify Qi and nourish kidney to improve the deficiency of spleen and insufficiency of kidney Qi in cancer patients after radiotherapy and chemotherapy. Furthermore, holistic conditioning is also important to improve the quality of sleep.The case was a post-operative gastric cancer patient, after long-term chemotherapy, the patient suffered from deficiency of spleen and stomach Qi and mental disorder.The case obtained good curative effect after treated with tonifying Qi, invigorating spleen and nourishing blood and tranquilizing mind. The accurate diagnosis and treatment fully reflected Professor LIN Shengyou''s experience in treating insomnia in cancer patients in cancer patients after radiotherapy and chemotherapy.Conclusion] Professor LIN Shengyou pays attention to the regulation of Yin and Yang in the treatment of insomnia in cancer patients after radiotherapy and chemotherapy. He emphasizes the relationship between deficiency and excess, and between the body''s anti-pathogenic factors and pathogenic factors. With the principle of "reinforcing deficiency, reducing surplus and regulating deficiency and excess", he attaches importance to invigorating spleen and kidney, and holistic treatment. The clinical effect is remarkable, which deserves to be used for reference.