熊常州 李世杰 牛华涛

【摘 要】 癌因性疲乏是恶性肿瘤患者的常见伴随症状之一，其归属于中医学“虚劳”范畴，能够对癌症患者的后续治疗、康复及生活质量产生严重影响。文章基于《黄帝内经》“悲则气消”理论，探究忧悲等负面情绪与癌因性疲乏的联系，总结癌因性疲乏的病理基础为“气消”；病机关键为忧悲久郁，肺脏生理功能受损，加之肝木乘土侮金，脏腑失和，气血阴阳亏虚；治疗总以补气畅情为要，兼以疏肝健脾益肾，提出补肺益气、疏肝理气、健脾益肾、以情调气等治法。旨在丰富中医药治疗癌因性疲乏的中医理论及方法，以期开拓一些新的临床思路。

【关键词】 黄帝内经；悲则气消；癌因性疲乏；负面情绪

【中图分类号】R730.6   【文獻标志码】 A    【文章编号】1007-8517（2023）08-0022-05

Abstract：Cancer-related fatigue is one of the common concomitant symptoms of patients with malignant tumor， which belongs to the category of “fatigue” in traditional Chinese medicine， and can have a serious impact on the follow-up treatment， rehabilitation and quality of life of cancer patients. Based on the theory of “Sadness Dissipating Qi” in Huangdi Neijing， this paper explores the relationship between negative emotions such as sadness and cancer-related fatigue， and concludes that the pathological basis of cancer-related fatigue is “Qi elimination”， and the key to the pathogenesis is sorrow and depression for a long time and damage to the physiological function of the lungs. in addition， liver wood insults gold， viscera disharmony， deficiency of qi and blood yin and yang. The treatment always focuses on tonifying qi and unblocking emotion， soothing the liver and invigorating the spleen and kidney， and putting forward the treatment methods of tonifying the lung and nourishing qi， soothing the liver and regulating qi， invigorating the spleen and kidney， regulating qi with emotion and so on. The purpose of this study is to enrich the traditional Chinese medicine theories and methods of traditional Chinese medicine in the treatment of cancer related fatigue， in order to open up some new clinical ideas.

Key words：Huangdi Neijing; Sadness Dissipating Qi;Cancer Related Fatigue;Negative Emotion

癌症目前是全球第二大死因，每年约有1千万人死于癌症，全球大约六分之一的死亡由癌症造成［1］。癌因性疲乏（cancer related fatigue，CRF）是一种以躯体、情感或认知上的，与癌症患者近期活动量不相符的疲乏感或疲惫感，其通常是一种痛苦的、持续的、主观上的感受，与癌症本身或癌症的治疗有关，是恶性肿瘤患者的常见伴随症状之一［2］，发病率高达60%～90%［3-4］。CRF可见于癌症的发生、发展及治疗的各个时期，可对患者的后续治疗、康复及生活质量产生了严重影响。中医学中并无CRF病名，根据其临床表现，多从“虚劳”“血虚”“痿证”论治。

目前大多医家认为CRF主要病因为肿瘤消耗气血津液、感受外邪及抗肿瘤治疗导致脏腑气血阴阳耗损、痰瘀等病理产物内郁，治疗上多从补益入手，调补先天及后天，以补脾益肾佐以解毒抗癌［5］。……