石潇 周慧灵 刘铸 黎雪 林洪生

摘要 肺癌无论从发病率还是死亡率来看，在恶性肿瘤中均居我国首位，其发病隐匿，一经发现大多就是中晚期。虽然西医有很多治疗手段，但是在提高治愈率的同时，常因治疗后的不良反应给患者的身心造成了极大的影响。中药的应用不仅能改善患者的症状，提高治疗积极性，同时能配合西医治疗起到“减毒增效”的作用。此外，现代许多药理研究表明，具有软坚散结功效的中药可通过抑制肿瘤细胞的增殖、诱导凋亡、增强机体免疫力等途径达到抗肿瘤的作用。现简要介绍林洪生教授以软坚散结法治疗肺癌的临证经验以及用药规律，希望能为临床工作者提供治疗思路。

关键词 软坚散结法;肺癌;中医疗法;固本清源;分阶段治疗;临床经验;医案; @ 林洪生

Abstract The incidence and mortality of lung cancer ranks the first among malignant tumors.Its onset is hidden.Once discovered，it is mostly in the middle and late stages.Although Western medicine has many treatment methods，while improving the curative rate，the side effects after treatment often have a great impact on the patient′s body and mind.The application of traditional Chinese medicine（TCM）can not only improve the symptoms of patients，and increase the enthusiasm for treatment; meanwhile，it plays a role of “reducing poison and increasing efficiency” in cooperation with Western medicine.In addition，many modern pharmacological studies have shown that TCM with the effect of softening hardness and dissipating mass can achieve anti-tumor effects by inhibiting the proliferation of tumor cells，inducing apoptosis，and enhancing the body′s immunity.This paper briefly introduces Professor LIN Hongsheng′s clinical experience in the treatment of lung cancer with softening hardness and dissipating mass method.It is hoped to provide treatment ideas to clinicians.

Keywords Softening hardness and dissipating mass method; Lung cancer; Traditional Chinese Medicine therapy; Strengthening the essence and correcting the source; Staged therapy; Clinical experience; Clinical case; @ LIN Hongsheng

中圖分类号：R242;R734.2文献标识码：Bdoi：10.3969/j.issn.1673-7202.2021.09.025

林洪生教授从事肿瘤的中西医结合临床和基础研究近50年，创新性地提出中医治疗肿瘤“固本清源”的理论，在治疗肺癌方面积累了丰富的经验，我们现总结林教授以软坚散结法治疗肺癌的临证经验。

1 软坚散结法的历史沿革

从汉代至今，从萌芽至成熟，软坚散结法治疗癥瘕积聚已有近两千多年的历史，历代医家通过大量临床实践，留下了许多软坚散结方，为后世医家治疗肿瘤留下了宝贵的经验。

中医常称癌为“岩”，认为其像岩石状，质地坚硬，表面凹凸不平，有毒根结于体内。《说文解字》中“坚”“结”本义指坚硬、板结、疙瘩，引申到医学中可指疾病状态下的病理产物坚硬难以祛除，积聚不易散开。……