对中医辨证论治与西医个体化治疗肿瘤的一点思考

近年西医治疗肿瘤的观念发生了较大转变，开始逐渐重视患者的整体生存状态。最近随着靶向药物的出现，发现同样的肿瘤和病理分型，因没有相同的治疗靶点，同一药物的疗效迥异；不同的肿瘤，因存在相同的治疗靶点，用相同的药物治疗，同样可收到较好疗效。由此西医提出了重视个体化治疗的观点。中医辨证论治治疗肿瘤时，相同的肿瘤，辨证分型不同，治疗方药不同；不同的肿瘤，辨证分型相同，可用相同的方药治疗。“证同治亦同”、“靶点相同治亦同”体现出西医的个体化治疗与中医辨证论治高度相似。本文重点围绕“同病异治”、“异病同治”来详细论述个体化治疗与辨证论治的相同点，从而说明中医辨证论治的科学性，强调坚持辨证论治是中医治疗肿瘤的精髓，同时也指出中医辨证论治现阶段存在的问题及解决方法。

Thinking on syndrome differentiation treatment and personalized therapy for tumor

The concepts of Western medicine in treating tumor have changed markedly in recent years, and begun to put more emphasis on the whole survival status of patients. With recent emergence of targeted drugs, it was found that curative effects of the same targeted drugs in treating patients with the same tumor type even the same tumor pathological subtype but different therapeutic targets may be different. On the contrary, the curative effects of different targeted drugs in treating patients with different tumor types but the same therapeutic targets may be similar. Accordingly, the viewpoint of personalized therapy is advocated in Western medicine. Under the guidance of syndrome differentiation treatment in traditional Chinese medicine （TCM）, patients with the same tumor and different syndromes should be treated by different herbs, and patients with different tumor and the same syndrome should be treated by the same herbs. Both the theories of ＂the same treatment for the same syndrome＂ and ＂the same treatment for the same therapeutic target＂ indicate that personalized therapy in Western medicine is similar to TCM syndrome differentiation treatment. The article focuses on ＂different treatments for the same disease＂ as well as ＂the same treatment for different diseases＂ to describe the similar points between personalized therapy and TCM syndrome differentiation treatment and thereby proves that TCM syndrome differentiation treatment is a scientific and essential approach in treating tumor. At the same time, the article also points out the problems and solution methods of TCM syndrome differentiation treatment.