国医大师何任教授辨治食管癌“噎膈三病”与处方集验  

National Medical Master HE Ren’s Treatment of Esophageal Cancer“Three Diseases of Choking and Diaphragm”and the Collection of Experimental Prescriptions

作　　者：隋新兵 李沁仪 何若苹[2] 顾锡冬[3] SUI Xinbing;LI Qinyi;HE Ruoping(Hangzhou Normal University,The Affiliated Hospital of Hangzhou Normal University,Hangzhou(310015),China;Zhejiang Provincial Hospital of Chinese Medicine)

机构地区：[1]杭州师范大学,杭州310015 [2]浙江中医药大学附属第三医院 [3]浙江中医药大学附属第一医院

出　　处：《浙江中医药大学学报》2024年第9期1136-1140,共5页Journal of Zhejiang Chinese Medical University

基　　金：浙江省自然科学基金项目(LY22H290004)。

摘　　要：[目的]总结首届“国医大师”何任教授治疗食管癌噎膈的学术经验。[方法]通过学习何任教授的学术著作,提炼其治疗食管癌噎膈的学术经验,并通过频数分析221张初诊食管癌患者的处方,归纳何任教授治疗食管癌噎膈处方的用药规律和常用药对,并附验案加以佐证。[结果]何任教授将食管癌噎膈患者按照痰气互结、痰瘀交阻和气阴两虚三型辨证论治,分别给予轻扬利膈、辛香通降和辛滑润养的基本方治疗。痰气互结型常用基础方为姜半夏、柴胡、山慈菇、沉香曲、乌药、制香附;痰瘀交阻型常用基础方为山慈菇、川朴、姜半夏、三棱、莪术、丹参;气阴两虚型常用基础方为党参、黄芪、猪苓、茯苓、枸杞子、女贞子。单味中药使用频次居前的有黄芪、党参、白花蛇舌草等;使用频次较高的药对为党参+黄芪、猫人参+白花蛇舌草等。所附验案属噎膈之痛膈,痰瘀交阻,治以辛香通降、兼理血络,取得较好疗效。[结论]何任教授对食管癌噎膈的诊疗病证结合,噎膈三病的论述丰富了其治疗肿瘤“不断扶正,适时祛邪,随证治之”的理论,提出的轻扬利膈、辛香通降和辛滑润养治法及基本方为食管癌各期患者的诊疗提供了有益的参考。[Objective]To summarize the academic experience of the first“National Medical Master”Professor HE Ren in the treatment of esophageal cancer choking.[Methods]By studying Professor HE Ren’s academic works,distilling his academic experience in treating esophageal cancer with dysphagia,and conducting a frequency analysis of the prescriptions of 221 initial esophageal cancer patients to summarize the dosage regimen and frequently used drug pairs of Professor HE’s treatment for esophageal cancer with dysphagia,with case histories provided for verification.[Results]The top herbs used in single prescriptions were milkvetch root,tangshen and spreading hedyotis herb,etc.The most frequently used herb pairs were tangshen+milkvetch root and root of valvate actinidia+spreading hedyotis herb,etc.Professor HE Ren treated patients according to three types of diagnosis:syndrome of intermingled phlegm and Qi,phlegm-stasis blocking and deficiency of both Qi and Yin,and gave the basic prescriptions of light-raising and diaphragm-inducing,pungent-perfuming and subduing and pungent-smoothing and nourishing,respectively.The common basic prescription herbs of syndrome of intermingled phlegm and Qi were ginger processed pinellia,radix bupleuri,cremastrae pseudobulbus,acquilaria leaven,combined spicebush root and nutgrass galingale rhizome.The common basic prescription herbs of phlegm-stasis blocking were cremastrae pseudobulbus,magnoliae officmalis cortex,ginger processed pinellia,sparganii rhizoma,curcumae rhizoma and Danshen root.The common basic prescription herbs of deficiency of both Qi and Yin were tangshen,milkvetch root,polyporus,Indian buead,lycii fructus and glossy privet fruit.The attached test case was the pain of choking diaphragm,phlegm and blood stasis,with the treatment of incense and blood collaterals,and it achieved a better effect.[Conclusion]The discussion of the three diseases of choking and diaphragm enriched HE Ren’s diagnosis and treatment of choking and diaphragm in esophageal cancer,and the proposed tre

关 键 词：食管癌 噎膈 扶正祛邪 用药经验 医案 何任 数据分析 国医大师 

分 类 号：R256[医药卫生—中医内科学]