迟莉丽从“虚毒瘀”论治胰腺导管内乳头状黏液性肿瘤学术思想撷英  

Academic thoughts of CHI Lili in treating intraductal papillary mucinous neoplasm of the pancreas from the perspectives of deficiency,toxicity and blood stasis

作　　者：刘萍[1] 迟莉丽[2] 孙大娟[2] LIU Ping

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学附属医院,山东济南250011

出　　处：《中医临床研究》2023年第34期129-133,共5页Clinical Journal Of Chinese Medicine

基　　金：山东省中医药科技发展计划项目(2019-0188)。

摘　　要：胰腺导管内乳头状黏液性肿瘤(Intraductal Papillary Mucinous Neoplasm,IPMN)是胰腺癌癌前病变,对症处理及手术治疗是现代医学治疗该病的主要方法。临床上,非手术治疗后患者可反复发作胰腺炎,手术治疗患者术后亦有复发概率,且随时间延长概率将增加。迟莉丽教授基于“虚、毒、瘀”思想,发挥中医辨证论治IPMN的优势及特色,并提出该病的中医发病机制及治则治法。迟教授认为,该病初期以浊瘀闭阻不通,积聚脏腑,伏而生热毒为该病发病的关键病机,以清浊毒、化瘀积为基本治则,代表方为自拟方清热化浊方。该病稳定阶段以浊毒积聚体内,致脏腑功能失调为该病发展条件,以运脾消浊解毒为基本治则,代表方为自拟方醒脾化浊汤。该病恢复期以脾胃虚弱,致脏腑失养为发病之根本,以健脾益气固本为基本治则,代表方为自拟方参苓健脾汤。她强调,IPMN病因病机变化复杂,在疾病不同发展阶段针对性治疗,同病异治,辨证施治。充分发挥中医治疗癌前病变的优势,抓住病情发展变化中心,直达病所,对降低IPMN的发病率以及延缓病情进展具有重要的临床意义。Intraductal papillary mucinous neoplasm is a precancerous lesion of pancreatic cancer.Symptomatic management and surgical treatment are the main methods of modern medicine to treat this disease.However,patients may have recurrent pancreatitis after non-surgical treatment,and patients with surgical treatment also have a recurrence probability after surgery,and the probability will increase with the extension of time.Professor CHI Lili gave full play to the advantages and characteristics of TCM syndrome differentiation in treating intraductal papillary mucinous neoplasm based on deficiency,toxicity and blood stasis,and proposed the TCM pathogenesis and treatment of this disease.In the early stage of the disease,turbid stasis blocking obstruction,accumulation of organs,and heat toxicity are the key pathogenesis of the disease.With turbid toxin clearing and stasis accumulation as the basic treatment principles,the representative formula is self-designed Qingre Huazhuo decoction(清热化浊方).In the stable stage of the disease,turbidity toxin accumulates in the body and causes the dysfunction of the viscera,which is the condition for the development of the disease.The basic treatment is to transport the spleen to eliminate turbidity and detoxification,and the representative prescription is the self-made Xingpi Huazhuo decoction(醒脾化浊汤).During the convalescence of the disease,the weakness of the spleen and stomach,resulting in the loss of nourishment of the Zangfu organs(脏腑),is the root of the disease,and the basic treatment is to strengthen the spleen and Qi(气),and the representative prescription is self-prepared Shenling Jianpi decoction(参苓健脾汤).The etiology and pathogenesis of intraductal papillary mucinous neoplasm are complicated,and targeted treatment is performed in different stages of disease development.Giving full play to the advantages of TCM in the treatment of precancerous lesions,seizing the center of disease development and change,reaching the disease center,has important clini

关 键 词：胰腺导管内乳头状黏液性肿瘤 分期辨证论治 名医经验 

分 类 号：R273[医药卫生—中西医结合]