朱玲玲基于天癸理论论治多发性骨髓瘤经验介绍

多发性骨髓瘤（MM） 是老年人多发的血液恶性肿瘤，严重危害患者健康。朱玲玲教授临床上发现天癸与MM的发生、发展关系密切，认为MM多虚实夹杂，病机以天癸竭、肝肾亏虚为本，痰毒瘀为标，合而致病。朱教授临证提倡分期辨治，早期以痰毒瘀阻证、气滞血瘀证为主，选用黄连解毒汤合身痛逐瘀汤以清热解毒、活血化瘀，血府逐瘀汤以活血化瘀、理气止痛；中期以肾虚血瘀证为主，选用独活寄生汤以补肾活血；晚期以肝肾阴虚证、脾肾阳虚证、气血亏虚证为主，分别选用六味地黄丸合芍药甘草汤以益肾填精、柔肝止痛，附子理中丸或肾气丸合四君子汤以温中散寒、补益脾肾，八珍汤以益气健脾、补血活血。同时，朱教授强调临床应中西医结合治疗，以达到增效减毒、提高患者生活质量、降低疾病复发、延长生存周期的效果。

Introduction of ZHU Lingling''s Experience in Treating Multiple Myeloma Based on the“Tiangui” Theory

Abstract：Multiple myeloma (MM) is a common hematologic malignancy in the senile，which seriouslyendangers the health of patients. Professor ZHU Lingling clinically finds that Tiangui is closely related to theoccurrence and development of MM. She considers that MM is usually with deficiency-excess complex，the pathogenesis is based on Tiangui exhausion， liver-kidney deficiency is the root， phlegm， toxin andstasis are the tip， and the combination of the above causes the disease. Professor ZHU advocates thesyndrome differentiation and treatment by stages. In the early stage，phlegm and toxin obstruction，and qistagnation with blood stasis were the main syndromes. Huanglian Jiedu Decoction combined with ShentongZhuyu Decoction can be used to clear heat and resolve toxins and invigorate blood and dissolve stasis；Xuefu Zhuyu Decoction can be used to invigorate blood and dissolve stasis and rectify qi and relieve pain. Inthe middle stage，the syndrome of kidney deficiency and blood stasis is the main one，and Duhuo JishengDecoction can be used to supplement kidney and invigorate blood. In the late stage， the liver-kidney yindeficiency syndrome， spleen-kidney yang deficiency syndrome and qi-blood deficiency syndrome aremain ones. Liuwei Dihuang Pills combined with Shaoyao Gancao Tang can be used to boost kidney andreplenish essence and soften liver and relieve pain；Fuzi Lizhong Pills or Shenqi Pills combined with SijunziDecoction can be used to warm the center and dissipate cold，supplement and boost spleen and kidney；Bazhen Decoction can be used to boost qi and fortify the spleen and supplement and invigorate blood. At thesame time，Professor ZHU stresses that the clinical treatment should integrate both Chinese and westernmedicine to achieve the purpose of enhancing efficiency and reducing toxin，improving the quality of life ofpatients，reducing disease recurrence and extending the life cycle.