从“痰瘀毒”病机解构当归贝母苦参丸在肿瘤中的应用  

Deconstructing the Application of Danggui Beimu Kushen Pill in Tumor from the Pathogenesis of Phlegm-stasis-toxin

作　　者：陈滨海 张光霁[2] CHEN Binhai;ZHANG Guangji(The Second Affiliated Hospital of ZheJiang Chinese Medical University,Hangzhou 310005;ZheJiang Chinese Medical University)

机构地区：[1]浙江中医药大学附属第二医院,杭州310005 [2]浙江中医药大学

出　　处：《浙江中医药大学学报》2024年第6期664-668,共5页Journal of Zhejiang Chinese Medical University

基　　金：国家自然科学基金重点项目(82030119);浙江省中医药科技计划项目(2022ZB148)。

摘　　要：[目的]从“痰瘀毒”病机探讨当归贝母苦参丸在肿瘤临床治疗中的运用。[方法]从《灵枢》相关论述出发,论述肿瘤发生发展的重要病机,同时在系统阐述“痰”“瘀”“毒”病机基础上解构当归贝母苦参丸的组方机理,并列举相关临床案例。[结果]从恶性肿瘤的病机来看,“痰瘀互结”是恶性肿瘤重要的成形性病机,“毒”是恶性肿瘤重要的恶性属性病机,可以总结为“无痰瘀,不成形”和“无毒邪,不恶性”。当归贝母苦参丸的组方原理可以与恶性肿瘤“痰瘀毒”病机相对应,总结为化痰祛瘀解毒法。所举2则案例,案例1患者为前列腺癌术后出现小便不利,因患者久为痰瘀之体,手术之后,络脉更损,痰瘀停滞,气化不利,故用当归贝母苦参丸化痰祛瘀解毒加通淋利尿之品而愈;案例2患者为肾癌晚期肿瘤病灶破溃而出现全程尿血,因患者痰瘀毒胶结不化,久而蕴热,损脉破络,致使肾络受伤,迫血外溢,故用当归贝母苦参丸和犀角地黄汤清热通淋、凉血止血而收功。[结论]从“痰瘀毒”病机解构当归贝母苦参丸,可以更好地理解该方并在肿瘤临床上加以应用。[Objective]To explore the clinical application of Danggui Beimu Kushen Pill in tumor from the pathogenesis of phlegm-stasis-toxin.[Methods]Based on the relevant discussion of Lingshu,the important pathogenesis of tumor occurrence and development was discussed.Meanwhile,the mechanism of formulation of Danggui Beimu Kushen Pill was deconstructed on the basis of the pathogenesis of phlegm,stasis and poison,and related clinical cases were listed.[Results]The pathogenesis of malignant tumor was“no phlegm stasis,no shape”and“no toxic evil,no malignancy”.The formulation principle of Danggui Beimu Kushen Pill was the method of eliminating phlegm and removing stasis and detoxifying.Two cases were examplifed,the patient in case 1 was prostate cancer after adverse urination,because the patient had the body of phlegm stasis for a long time,after the operation,the collaterals were more damaged with phlegm stasis stagnation and adverse gasification,so Danggui Beimu Kushen Pill was used to remove phlegm and stasis,added with diuretic products for cure;In case 2,the patient had the whole urine blood due to the rupture of the advanced tumor lesion of kidney cancer,because the patient had phlegm and poison glued together,the pulse was warm,resulting in kidney collateral injury and forced blood overflow,so Danggui Beimu Kushen Pill and Xijiao Dihuang Soup were used to clear heat and free strangury,and cool the blood to stop bleeding.[Conclusion]Deconstructing Danggui Beimu Kushen Pill from the pathogenesis of“phlegm-stasis-toxin”can better understand the decoction and apply it in tumor clinic.

关 键 词：恶性肿瘤 当归贝母苦参丸 病机 痰 瘀 毒 医案 临床应用 

分 类 号：R273[医药卫生—中西医结合]