基于子午流注理论探析林胜友辨治化疗后潮热之临证经验OA

[Objective]To summarize Professor LIN Shengyou's clinical experience in diagnosing and treating post-chemotherapy tidal fever based on the midday-midnight flowing of Qi-bloodpoint,midnight-noon ebb-flow theory.[Methods]Systematically collate and analyze Professor LIN's medical records concerning post-chemotherapy tidal fever,summarize Professor LIN's academic experience in diagnosis and treatment based on the midnight-noon ebb-flow theory,establish a"time-pathogenesis-treatment-formula"framework by categorizing the temporal-pathological correspondence of tidal fever attacks according to the different periods,and include one verified case study.[Results]Professor LIN suggests that the core pathogenesis of this condition is the disruption of the temporal rhythm of visceral Qi and blood by chemotherapy toxins,and advocates using the timing of tidal fever onset as the key to syndrome differentiation.According to the principles of the midday-midnight flowing of Qi-bloodpoint,midnight-noon ebb-flow theory,tidal fever is categorized into four main pathological phases:Yin-Mao-Chen-Si(3:00-11:00)often relates to spleen deficiency with Qi sinking;Wu-Wei(11:00-15:00)typically indicates exuberance of heart fire,frequently rooted in spleen deficiency,blood insufficiency and affecting the heart;Shen-You-Xu-Hai(15:00-23:00)is attributed deficiency of kidney Yin;and Zi-Chou(23:00-3:00)involves deficiency of liver blood or retention of drug toxins.Corresponding to these four phases,Professor LIN has established a therapeutic framework emphasizing"time-based diagnosis and organ-time synchronized treatment".The respective treatment methods include invigorating the spleen stomach and replenishing Qi and elevating Yang,fortifying the spleen to clear heart fire,nourishing Yin to moisten wood and reducing fire,and nourishing blood to soften the liver and dispersing toxins,and the rescriptions are often modified combinations of classical formulae.Professor LIN emphasizes"leveraging timing to enhance drug efficacy",for instance,administering middle-supplementing and Yang-elevating decoctions in the early morning(Yin-Mao periods)and Yin-nourishing and Yang-subduing decoctions in the evening(Shen-You periods)or before sleeping(Hai period).The attached complex case of post-chemotherapy tidal fever in a lung cancer patient was treated effectively according to this"time-pathogenesis-treatment-formula"model by using a modified combination of prescriptions including Buzhong Yiqi Decoction with strict adherence to timed administration,validating the effectiveness of this model.[Conclusion]Professor LIN Shengyou has established a precise diagnostic and therapeutic model based on the Midday-Midnight Flowing of Qi-Bloodpoint,Midnight-Noon Ebb-Flow theory,characterized by"deducing visceral conditions from timing and treating according to the situation",Which can provide valuable reference and insight for traditional Chinese medicine in the treatment of post-chemotherapy tidal fever.