蔡小平治疗原发性肝癌经验  

Cai Xiao-ping′s Experience of Treating Primary Carcinoma of Liver

作　　者：罗银星[1] 蔡小平[1] LUO Yin-xing;CAI Xiao-ping(Affiliated Hospital of Henan Academy of Traditional Chinese Medicine,Zhengzhou,Henan,China,450004)

机构地区：[1]河南省中医药研究院附属医院,河南郑州450004

出　　处：《河南中医》2021年第2期211-215,共5页Henan Traditional Chinese Medicine

基　　金：河南省中医药青苗人才培养项目{豫中医科教[2018]6号}。

摘　　要：蔡小平教授根据原发性肝癌肝郁脾虚为本、瘀毒内结为标的基本病机,临证时以疏肝健脾化瘀解毒为治疗大法,创立了调肝散结方,在辨病的基础上进行辨证施治,随证加减。蔡教授提出,肝癌临床常见证型为肝郁脾虚证、瘀毒内结证、湿热内蕴证和肝肾阴虚证。肝郁脾虚证常用调肝散结基础方、逍遥散、六君子汤交替使用;瘀毒内结证属瘀阳毒者药用调肝散结方去香附、红花,加重楼、夏枯草、蟾酥、茵陈、栀子、滑石;瘀毒内结证属瘀阴毒者药用调肝散结方去黄芩、半枝莲、浙贝母,加干姜、附子、肉桂、吴茱萸;湿热内蕴证多用茵陈四苓散加赤芍、炒栀子、麦冬;肝肾阴虚证以滋水清肝饮为主方。蔡教授提倡治疗肝癌应中西并重,优势互补,可提高临床疗效和生活质量。According to the basic pathogenesis of primary carcinoma of liver with liver stagnation and spleen deficiency as primary and syndrome of accumulation of blood stasis and toxin as secondary,Professor Cai Xiao-ping always uses the method of soothing liver and invigorating spleen and resolving blood stasis and removing toxin in clinical practice.He has established the basic formula for regulating liver and dispersing blockage for syndrome differentiation based on disease differentiation to modify flexibly.Professor Cai Xiao-ping points out that the common clinical syndrome types of primary carcinoma of liver include syndrome of liver stagnation and spleen deficiency,syndrome of accumulation of blood stasis and toxin,syndrome of accumulation of dampness and heat,and syndrome of liver-kidney yin deficiency.For syndrome of liver stagnation and spleen deficiency,the basic formula for regulating liver and dispersing blockage,Free Wanderer Powder,and Six Gentlemen Decoction are used alternately.For syndrome of accumulation of blood stasis and toxin which belongs to stagnated yang and toxin,the basic formula for regulating liver and dispersing blockage removing Xiangfu(Rhizoma Cyperi) and Honghua(Flos Carthami) while adding Chonglou(Rhizoma Paridis),Xiakucao(Spica Prunellae),Chansu(Venenum Bufonis),Yinchen(Herba Artemisiae Scopariae),Zhizi(Fructus Gardeniae) and Huashi(Talcum) can be used.For syndrome of accumulation of blood stasis and toxin which belongs to stagnated yin and toxin,the basic formula for regulating liver and dispersing blockage removing Huangqin(Radix Scutellariae) and Banzhilian(Herba Scutellariae Barbatae) and Zhebeimu(Bulbus Fritillariae Thunbergii) while adding Ganjiang(Rhizoma Zingiberis),Fuzi(Radix Aconiti Lateralis Preparata),Rougui(Cortex Cinnamomi) and Wuzhuyu(Fructus Evodiae) can be used.For syndrome of accumulation of dampness and heat,Four Substances Powder with Poria Plus Virgate Wormwood adding Chishao(Radix Paeoniae Rubra),stir-fried Zhizi(Fructus Gardeniae) and Maidong(Radix Ophiopogonis) c

关 键 词：原发性肝癌 疏肝健脾化瘀解毒法 调肝散结方 肝郁脾虚证 瘀毒内结证 湿热内蕴证 肝肾阴虚证 蔡小平 

分 类 号：R249.1[医药卫生—中医临床基础]