基于络病理论分期论治大肠癌围手术期  

Phased perioperative management of colorectal cancer from the perspective of collateral diseases

作　　者：郑继雯 王进[2] 李华山[3] ZHENG Jiwen;WANG Jin;LI Huashan(Beijing University of Chinese Medicine,Beijing 100029;Hubei University of Chinese Medicine;Guang’anmen Hospital,China Academy of Chinese Medical Sciences)

机构地区：[1]北京中医药大学,北京100029 [2]湖北中医药大学 [3]中国中医科学院广安门医院

出　　处：《现代中医临床》2023年第1期87-89,共3页Modern Chinese Clinical Medicine

基　　金：国家自然科学基金资助项目(No.81673988,No.82174390)。

摘　　要：大肠癌是病变范围包括直肠至盲肠整段的常见消化道恶性肿瘤,其发病率呈逐年上升趋势。《临证指南医案》首次提出络病概念,并将癥瘕归于络病,提出肿瘤络病论。大肠癌可归属于中医学“癥瘕”“积聚”“肠瘤”等范畴,从络病论治,对大肠癌围手术期患者实施中医药分期论治和康复方案:术前祛痰化瘀、解毒通络、搜剔络邪,术期补气养血、健脾通腑、温通营络,术后补脾益肾、补虚和络、荡涤余毒。结合临床病案对基于络病理论分期论治大肠癌围手术期进行阐述。Colorectal cancer is a common type of malignant tumor of the digestive tract that covers the entire section from the rectum to the cecum, and its incidence is increasing year by year. The Case Records as a Guide to Clinical Practice for the first time put forward the concept of “collateral diseases”, to which “abdominal mass” belongs, thus establishing the theory about tumor based on collateral diseases. Colorectal cancer can be classified as “abdominal mass”, “accumulation-gathering” and “intestinal tumor” in traditional Chinese medicine. Based on the theory of collateral diseases, TCM phased treatment and recovery programs are implemented for perioperative management of patients with colorectal cancer: Before the operation, it is key to dispel phlegm and remove blood stasis, resolve toxins and unblock the collaterals, and remove the pathogenic factors in the collaterals. During the operation, the focus should be placed on supplementing qi and nourishing the blood, fortifying the spleen and dredging the bowels, and warming and unblocking the collaterals. After the operation, the priority becomes supplementing the spleen and nourishing the kidney, supplementing weakness and reconciling the collaterals, and removing the residual toxins. Combined with clinical cases, this paper elaborates on the perioperative management of colorectal cancer based on the theory of collateral diseases.

关 键 词：大肠癌 络病 中医药治疗 分期论治 

分 类 号：R273[医药卫生—中西医结合]