贺用和治疗原发性肝癌腹水的经验  

The Experience of He Yonghe in Treating Ascites of Primary Liver Cancer

作　　者：张晔铭 郑红刚[2] 贺用和[2] ZHANG Yeming;ZHENG Honggang;HE Yonghe(Graduate School of Beijing University of Traditional Chinese Medicine,Beijing 100029,China;Guang'anmen Hospital China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中国中医科学院广安门医院,北京100053

出　　处：《湖南中医药大学学报》2021年第5期746-748,共3页Journal of Hunan University of Chinese Medicine

基　　金：国家中医药管理局委托办事项目(GZY-GCS-2018-071)。

摘　　要：原发性肝癌腹水是常见的中晚期肝癌并发症之一。贺用和主任医师主张肝癌与腹水同治,强调肝癌“内风暗旋、肝风内动”的病机,将肝癌腹水分为气滞湿阻、脾虚湿盛、水热蕴结、血瘀水停、阳虚水泛、阴虚水停6种证型:气滞湿阻证,治以温中健脾,利水化湿,采用柴胡疏肝散加减;水热蕴结证,治以清热利湿,攻下逐水,采用茵陈蒿汤或中满分消丸加减;血瘀水停证,治以活血化瘀、行气利水,采用调营饮加减;阳虚水泛证,治以补益肾阳、利水渗湿,采用济生肾气丸加减;阴虚水停证,治以滋阴补肾、柔肝利水,采用六味地黄丸加减。Ascites of primary liver cancer is one of the common complications of middle and late stage liver cancer.Chief physician He Yonghe advocates the treatment of liver cancer and ascites together,emphasized the pathogenesis of"internal wind dark whirl,internal movement of liver wind"in liver cancer.He divides ascites of liver cancer into six syndromes:Qi stagnation and dampness obstruction,spleen deficiency and dampness accumulation,water heat accumulation,blood stasis and dampness obstruction,water flooding in Yang deficiency and water stopping in Yin deficiency.The syndrome of Qi stagnation and dampness obstruction should be treated by warming the spleen and invigorating the spleen and improving the hydration and dampness,and Chaihu Shugan Powder should be used.To treat the syndrome of water heat accumulation,it is necessary to clear heat and gain moisture,and to attack the water,modified Yinchenhao Decoction or Zhongman Fenxiao Pill should be used.Blood stasis and water stop syndrome should be treated with promoting blood stasis,Qi and water,modified Tiaoying Decoction should be used.Yang deficiency and water flooding syndrome should be treated by tonifying kidney Yang and benefiting water infiltration and dampness,modified Jisheng Shenqi Pill should be used.Yin deficiency and water stagnation syndrome should be treated by nourishing Yin and tonifying kidney,softening liver and promoting water,modified Liuwei Dihuang Pill should be used.

关 键 词：原发性肝癌 腹水 内风暗旋 肝风内动 贺用和 

分 类 号：R563.1[医药卫生—呼吸系统] R248[医药卫生—内科学]