中医肿瘤学杂志

肺癌属中医“肺积”范畴，其发病隐匿、进展迅猛，以正气内虚为核心，兼夹邪毒外侵、痰瘀互结、络脉失和等多重病机，且易发生多脏器转移，形成“一脏病损、多脏受累”的病变特点。叶天士的核心学术思想可为肺癌的辨证治疗提供重要指导，其卫气营血辨证理论，清晰揭示了肺癌“由浅入深、由气及血”的传变层次；久病入络思想，精准阐释了肺癌缠绵难愈、疼痛频发的病理本质，亦为虫类药的临床运用提供思路；而其始终强调的顾护阴液思想，可针对性契合肺癌不同病程阶段的阴虚病机，为该病的扶正治疗确立核心准则。本文结合现代中医肿瘤学研究，探讨叶天士学术思想在肺癌分期辨证、病机转化及并发症防治中的指导意义。

Lung cancer, categorized as “lung accumulation” in traditional Chinese medicine(TCM), is characterized by insidious onset and rapid progression. Its fundamental pathogenesis is internal deficiency of healthy qi,complicated by external invasion of pathogenic toxins,phlegm-stasis intermingling,and disharmony of the collaterals. Moreover, it often leads to multi-organ metastasis, forming a pathological feature of “impairment of one organ involving multiple organs.” Ye Tianshi's core academic thoughts can provide important guidance for the syndrome differentiation and treatment of lung cancer. His Wei-Qi-Ying-Xue(Defense, Qi,Nutrient,Blood) syndrome differentiation theory clearly reveals the progressive layers of lung cancer transformation “from the superficial to the deep, from qi to blood”. The concept of chronic diseases invading the collaterals accurately explains the pathological essence of the lingering nature and frequent pain in lung cancer,while also providing a rationale for the clinical use of insect-based medicinals. Furthermore, Ye Tianshi's consistent emphasis on protecting yin fluids aligns with the yin deficiency pathogenesis present at different stages of lung cancer,establishing core principles for its treatment of reinforcing the healthy qi. This article,integrating modern TCM oncology research,explores the clinical guiding value of Ye Tianshi's academic thoughts in the stage-based syndrome differentiation,pathogenesis transformation,and complication prevention and treatment of lung cancer.