陈卫建中药配合火针治疗直肠癌术后泄泻经验  

CHEN Weijian’s Experience in the Treatment of Diarrhea After Rectal Cancer Operation with Chinese Herbal Medicine plus Fire Needle

作　　者：许海莹 曹颖 蔡妍 杨婷 袁晨逸 陈滨海 陈卫建 XU Haiying;CAO Ying;CAI Yan(The Second Clinical Medical School of Zhejiang Chinese Medical University,Hangzhou(310053),China)

机构地区：[1]浙江中医药大学第二临床医学院,杭州310053 [2]浙江中医药大学附属第二医院

出　　处：《浙江中医药大学学报》2022年第12期1359-1362,1382,共5页Journal of Zhejiang Chinese Medical University

基　　金：浙江省中医药重点学科建设项目(2017XKA12)。

摘　　要：[目的]总结分析陈卫建教授中药配合火针治疗直肠癌术后泄泻的临床经验。[方法]通过跟师学习,整理医案,从病因病机、遣方用药规律和针刺原则等方面对陈师治疗直肠癌术后泄泻的经验进行归纳总结,分析其临证思路和治疗原理,并举验案一则佐证。[结果]陈师认为,直肠癌术后泄泻总属虚中夹实,病机在于脾肾两虚,兼有湿热痰瘀郁毒等余毒未清,故治疗上多以经验方调补脾肾、清解余毒,再根据患者病情进一步辨证分析,化裁运用;配合火针针刺八髎穴以调畅气血、益肾温阳、除湿解毒,临床疗效显著。所附医案证属脾肾亏虚、瘀毒内阻,法当调补脾肾、散瘀解毒,通过经验方加减配合火针治疗,患者泄泻明显减轻。[结论]陈师以中药联合火针治疗直肠癌术后泄泻,疗效甚佳,值得学习借鉴。[Objective]To summarize and analyze Professor CHEN Weijian’s clinical experience of Chinese herbal medicine plus fire needle in the treatment of diarrhea after rectal cancer operation.[Methods]Through following the teacher’s outpatient department,arranging the clinical medical records,this paper summarized Professor CHEN’s experience in treating diarrhea after rectal cancer operation from aspects of etiology and pathogenesis,medication regularities,and acupuncture mechanisms,and a typical case was presented to prove.[Results]Professor CHEN points out that the disease is mostly due to deficiency complicated with excess,and its pathogenesis is spleenkidney deficiency and residual toxins such as dampness,heat,phlegm,blood stasis and Qi stagnation.Therefore,the empirical prescription is used to tonify the spleen and kidney and clear away the residual toxins.On the basis of it,Professor CHEN often makes further syndrome differentiation analysis and application,combined with fire acupuncture at Baliao,which can regulate Qi and blood,benefit the kidney and warm Yang,and clear away the toxins and dampness.In this way,diarrhea after rectal cancer operation can be effectively alleviated.In the attached medical record,the syndrome type was spleen-kidney deficiency combined with retention of blood stasis and the toxin,the main treatment principle was to regulate and tonify the spleen and kidney,remove blood stasis and clear away the toxin.After the treatment of proven prescription plus fire needle,the diarrhea was significantly relieved.[Conclusion]Professor CHEN’s use of Chinese herbal medicine plus fire needle is an effective method in treating diarrhea after the rectal cancer operation,which is worthy of learning.

关 键 词：直肠癌 泄泻 调补脾肾 清解余毒 火针 经验 陈卫建 

分 类 号：R245[医药卫生—针灸推拿学]