从两例验案探讨中医治疗肝癌的临床优势  

Exploration on the Clinical Advantages of Traditional Chinese Medicine in Liver Cancer Treatment Based on Two Effective Cases

作　　者：潘艳丽 周瑞生 唐莹[3] 周岱翰[2] PAN Yan-li;ZHOU Rui-sheng;TANG Ying;ZHOU Dai-han(Gushengtang Traditional Chinese Medicine Clinic,Guangzhou 518112 Guangdong,China;The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China;Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]固生堂中医门诊部,广东广州518112 [2]广州中医药大学第一附属医院,广东广州510405 [3]广州中医药大学,广东广州510405

出　　处：《中医肿瘤学杂志》2024年第4期41-45,72,共6页Journal of Oncology in Chinese Medicine

基　　金：深圳市“医疗卫生三名工程”项目(编号:SZZYSM202311011);广州中医药大学高水平建设项目(编号:A1-2601-24-415-110Z11)

摘　　要：通过报道治疗两例肝癌的成功案例,探讨肝癌的中医辨证论治特色与临床疗效优势。周岱翰教授认为“肝火盛、脾气虚、肾水亏”是肝癌的核心病机,临床论治强调“熄肝火、益脾气、养肝阴、滋肾水”。“验案一”中医辨证为肝肾阴虚证,初期治疗予滋水涵木,攻补兼施;病程中期肝肾阴津得充,增加活血化瘀药,侧重攻邪;后期减少攻邪药物,中病即止,预防复发。“验案二”中医辨证为肝热血瘀证,治以清肝凉血,兼以健脾益气;同时予清肝祛瘀利胆法治疗门静脉高压以及滋阴补阳法缓解双乳疼痛。周岱翰教授结合“辨证论治”的原则,按照肝癌发病规律实施中医治疗全病程管理,应用“异法方宜,杂合以治”的理论,充分发挥中医治疗肝癌的独特优势,获得较好的临床疗效。Through reporting two successful cases of treating liver cancer,the characteristics of traditional Chinese medicine(TCM)syndrome differentiation and treatment and clinical curative effect of liver cancer were discussed.Professor Zhou Dai-han believed that“liver fire hyperactivity,spleen qi deficiency,and kidney water deficiency”were the core pathogeneses of liver cancer,and emphasized“draining liver fire,tonifying spleen qi,nourishing liver yin,and nourishing kidney water”in the clinical treatment.In case 1,the patient was found to be deficient in kidney and liver yin.In the early stage of disease,the treatment consisted of nourishing liver and kidney and strategies for simultaneous elimination and reinforcement;in the middle stage,kidney and liver yin was fully replenished,and the disease was treated with an increase in blood-activating and stasis-resolving medications while concentrating on the pathogen’s attack;in the late stage,fewer medications were used to combat the pathogen in order to stop the medicine as soon as possible after recovery and prevent the disease from relapsing.In case 2,the patient was diagnosed with syndrome of liver heat and blood stagnation.The treatments consisted of clearing liver heat,removing heat from blood,and invigorating spleen and reinforce qi.In addition,portal hypertension was treated with clearing liver heat,removing blood stasis,and draining bile.Besides,methods of nourishing yin and tonifying yang were used to relieve bilateral breast pain.Combined with the principle of“syndrome differentiation and treatment”,Professor Zhou Dai-han implemented the whole course management of TCM treatment according to the pathogenesis regularity of liver cancer. By applying the theory of“ treatment witha combination of diverse methods and prescriptions”, Professor Zhou Dai-han sufficiently exerted the uniqueadvantages of TCM in treating liver cancer and achieved good clinical efficacy.

关 键 词：原发性肝癌 辨证论治 全病程管理 异法方宜 

分 类 号：R273[医药卫生—中西医结合] R735.7[医药卫生—中医肿瘤科]