基于气陷理论探析恶性肿瘤术后中医药治疗与康复思路  

Postoperative Treatment and Rehabilitation of Malignant Tumor Based on the Theory of Qi Sinking in Traditional Chinese Medicine

作　　者：孙千惠 朱广辉 许博文 张英[1] 李杰[1] SUN Qianhui;ZHU Guanghui;XU Bowen;ZHANG Ying;LI Jie(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing,100053;Beijing University of Chinese medicine)

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

出　　处：《中医杂志》2024年第11期1120-1125,共6页Journal of Traditional Chinese Medicine

基　　金：国家重点研发计划(2023YFC3503300);首都卫生发展科研专项(首发2022-1-4151);中央高水平中医医院临床研究和成果转化能力提升项目(HLCMHPP2023001);北京市中医管理局重大疑难疾病中西医协同攻关项目(2023BJSZDYNJBXTGG-013)。

摘　　要：“气陷”作为中医学理论中的重要概念,是对大气下陷思想内核的承袭和延伸,探析气陷理论中宗气、中气和肾气下陷概念,认为宗气下陷、中气滞陷、肾气虚陷是恶性肿瘤术后损伤核心病机。锚定扶正举陷诸法辨治以掣引升陷,其中肺金戕损,心阳亏虚而宗气下陷,治以升陷汤合桂枝汤加减温补心肺,升举宗气,恢复呼吸功能;脾败枢折,肝失条达而中气滞陷,治以补中益气汤加减温补中气,升阳举陷,促进胃肠康复;源绝精亏,肝失敛藏而肾气虚陷,治以六味地黄丸合升麻柴胡汤加减,旨在滋肾敛肝,固元升提,改善盆底功能障碍。结合不同病势、病期加减配伍,为恶性肿瘤术后中医药治疗与康复提供新思路。As an important concept in Chinese medicine theory,"qi sinking"is the inheritance and extension of the thought core of sinking of qi in whole body.This article explored the concept of sinking of pectoral qi,center qi,and kidney qi in the theory of qi sinking,and believed that sinking of pectoral qi,stagnation and sinking of center qi,deficiency and sinking of kidney qi were the core pathogenesis of postoperative injury in malignant tumours.Anchored to the method of reinforcing healthy qi and lifting the sunken,this article recommended to identify pattern and treat by guiding supplement and lifting the sunken.For lung gold impairment,heart yang depletion,and pectoral qi sinking,the treatment is to warm and supplement heart and lung,lift pectoral qi,and restore the respiratory function by modified Shengxian Decoction(升陷汤)plus Guizhi Decoction(桂枝汤);for spleen depletion and pathways blockage,liver failing to act freely,and center qi stagnation and sinking,the treatment is to warm and supplement center qi,raise yang and lift the sunken,and restore the digestive function by modified Buzhong Yiqi Decoction(补中益气汤);for source exhausted and essence deficiency,liver qi hiding,and kidney qi deficiency to inward invasion,the treatment is to nourish the kidney and astringe the liver,consolidate the original qi and lift qi,improve the pelvic floor dysfunction,and protect the kidney function by modified Liuwei Dihuang Pill(六味地黄丸)plus Shengma Chaihu Decoction(升麻柴胡汤).Modification need base on different disease patterns and stages,and new ideas for postoperative traditional Chinese medicine treatment and rehabilitation of malignant tumours were provided.

关 键 词：气陷 恶性肿瘤 术后康复 宗气 中气 

分 类 号：R273[医药卫生—中西医结合]