李家庚运用六经辨证结合脏腑辨证治疗原发性肝癌经验  

LI Jiageng's Experience in Treating Primary Liver Cancer based on Six-channel and Zang-fu(脏腑)Pattern Differentiation

作　　者：齐淯 徐波[1] 李佩 蒋跃文[1] 胡作为[3] 李家庚(指导)[1] QI Yu;XU Bo;LI Pei;JIANG Yuewen;HU Zuowei(Hubei University of Chinese Medicine,Wuhan,430065;Wuhan Hospital of Traditional Chinese Medicine;Wuhan No.1 Hospita)

机构地区：[1]湖北中医药大学,湖北省武汉市430061 [2]武汉市中医医院 [3]武汉市第一医院

出　　处：《中医杂志》2023年第3期231-235,共5页Journal of Traditional Chinese Medicine

基　　金：全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号)。

摘　　要：总结李家庚教授运用六经辨证结合脏腑辨证治疗原发性肝癌的经验。认为肝癌的发生发展可表现为六经病证,临证以六经辨证为主,提出肝癌发病本于少阳经、厥阴经,治宜通利枢机,常用小柴胡汤、四逆散、双合汤、鳖甲煎丸合乌梅丸;并病太阳经,治宜解表散邪,常用柴胡桂枝汤、小柴胡汤合银翘散或加减葳蕤汤、麻黄升麻汤;并病阳明、太阴经,治宜补虚泻实,常用五味消毒饮、大柴胡汤、茵陈蒿汤、柴胡六君子汤、柴胡桂枝干姜汤;并病少阴经,治宜调和阴阳,常用六味地黄丸合一贯煎、八味地黄丸合右归丸。同时以脏腑辨证为辅,通过辨舌脉判别脏腑虚实,用药补不足而损有余,截断脏腑传变之势。This paper summarized LI Jiageng's experience in treating primary liver cancer based on six-channel and zang-fu(脏腑)pattern differentiation.It is believed that the occurrence and progression of liver cancer conforms to the characteristics of six-channel diseases,therefore,six-channel pattern differentiation is mainly used in clinical practice.As liver cancer is initially rooted in shaoyang(少阳)and jueyin(厥阴)channels,the treatment principle is unblocking the cardinal of qi movement,commonly with Xiaochaihu Decoction(小柴胡汤),Sini Powder(四逆散),Shuanghe Decoction(双合汤),or Biejiajian Pill and Wumei Pill(鳖甲煎丸合乌梅丸).If taiyang(太阳)channel is involved as well,it is recommended to release the exterior and dissipate pathogen,using Chaihu Guizhi Decoction(柴胡桂枝汤),Xiaochaihu Decoction with Yinqiao Powder or modified Weirui Decoction(小柴胡汤合银翘散或加减葳蕤汤),or Mahuang Shengma Decoction(麻黄升麻汤).If yangming(阳明)and taiyin(太阴)channel diseases are accompanied,the treatment should be supplementing deficiency and draining excess,commonly with Wuwei Xiaodu Beverage(五味消毒饮),Dachaihu Decoction(大柴胡汤),Yinchenhao Decoction(茵陈蒿汤),Chaihu Liujunzi Decoction(柴胡六君子汤),or Chaihu Guizhi Ganjiang Decoction(柴胡桂枝干姜汤).For the condition accompanied with shaoyin(少阴)diseases,it is advised to regulate and harmonize yin and yang,and the commonly used formulas were Liuwei Dihuang Pill with Yiguan Decoction(六味地黄丸合一贯煎),or Bawei Dihuang Pill with Yougui Pill(八味地黄丸合右归丸).Simultaneously,zang-fu pattern differentiation is used as supplement,where the deficiency and excess of zang-fu organs is judged by tongue and pulse manifestations.The treatment principle is to curb a surplus and supplement deficiency,thereby cutting off the transmission and change of the zang-fu organs.

关 键 词：原发性肝癌 六经辨证 脏腑辨证 少阳 厥阴 名医经验 李家庚 

分 类 号：R249[医药卫生—中医临床基础] R273[医药卫生—中医学]