陆拯“健脾清肠解毒”治疗结肠癌经验举隅  

LU Zheng’s Experience in the Treatment of Colon Cancer by“Invigorating Spleen,Clearing Intestine and Detoxifying”

作　　者：刘亚铭 傅睿[2,3] 陈明显[2,3] 陆拯(指导)[2,3] LIU Yaming;FU Rui;CHEN Mingxian(Zhejiang Chinese Medical University,Hangzhou(310053),China;Tongde Hospital of Zhejiang Province;Zhejiang Province Academy of Traditional Chinese Medicine)

机构地区：[1]浙江中医药大学,杭州310053 [2]浙江省立同德医院 [3]浙江省中医药研究院

出　　处：《浙江中医药大学学报》2024年第9期1154-1158,共5页Journal of Zhejiang Chinese Medical University

基　　金：国家中医药管理局全国中医临床优秀人才研修项目(国中医药人教函[2022]1号);局省共建郁病防治研究重点实验室(No:GZY-ZJ-SY-2402);浙江省551卫生人才培养工程(浙卫办[2021]40号)。

摘　　要：[目的]总结国医名师陆拯教授“健脾清肠解毒”治疗结肠癌的临证经验。[方法]通过门诊跟诊学习,病案收集整理,查找结肠癌相关文献及中医典籍,研习陆拯教授所著之《毒证论》,结合教授的临证释义,探讨结肠癌的病因病机,阐释结肠癌的治疗方法为“毒证四层总纲”指导下的“健脾清肠解毒”,归纳其临证辨证施治要点及组方用药规律,并附验案加以佐证。[结果]陆拯教授认为结肠癌基本病机是脾胃元气受损、癌毒蓄积于肠,并进一步指出脾胃元气受损是结肠癌发生、发展的前提,癌毒蓄积于肠是结肠癌发生、复发和转移的关键,临证治疗当着眼于恢复脾胃元气,清除肠中湿、热、痰、瘀等内生邪气以及残余癌毒,条畅肠腑气机,即以“健脾清肠解毒”为指导思想,根据患者术后具体症状,归纳为湿热毒蕴、痰瘀毒阻、瘀血毒壅、阳虚寒毒、阴虚热毒五种证型,基于扶正拔毒并举的理念,分别以清热解毒、化痰祛瘀、化瘀逐毒、温阳拔毒、滋阴败毒论治,从而祛除术后余毒,杜绝新生癌毒。所举医案应用“健脾清肠解毒”法治疗后症状改善,生活质量提高,随访无肿瘤复发转移。[结论]陆拯教授“健脾清肠解毒”治疗结肠癌的临证经验,展示了陆拯毒证理论在肿瘤治疗中的应用,为结肠癌的中医辨治提供了借鉴。[Objective]To summarize the clinical experience of Professor LU Zheng,in the treatment of colon cancer by“strengthening spleen and clearing intestine and detoxifying”.[Methods]Through outpatient follow-up study,case collection and collation,looking up the literature and TCM classics related to colon cancer,studying Professor LU Zheng’s“DU Zheng Opinions”,combining with clinical interpretation,this article discussed the etiology and pathogenesis of colon cancer,explained the treatment method of colon cancer as“strengthening spleen and clearing intestines and detoxifying”under the guidance of“four-layer general principle of toxin syndrome”,summarized the key points of clinical syndrome differentiation and treatment and the rules of prescription and drug use,finally provided examples to illustrate it.[Results]Professor LU Zheng believed that the basic pathogenesis of colon cancer was the damage of spleen and stomach vitality and the accumulation of cancer toxin in the intestine,and further pointed out that the damage of spleen and stomach vitality was the premise of the occurrence and development of colon cancer,and the accumulation of cancer toxin in the intestine was the key to the occurrence,recurrence and metastasis of colon cancer.The clinical treatment should focus on restoring the vitality of spleen and stomach,clearing the endogenous evil factors such as dampness,heat,phlegm and stasis in the intestine and the residual cancer toxin,clearing the intestinal Qi mechanism,that was,taking“strengthening spleen and clearing intestines and detoxifying”as the guiding ideology,according to the specific symptoms of patients after operation,it was summarized into five syndromes:damp-heat toxin,phlegm and stasis toxin,stasis and blood toxin,Yang deficiency cold toxin,Yin deficiency heat toxin.According to the concept of supporting the essence and removing the toxin,the treatments were heat-clearing and detoxification,phlegm-removing and stasis-removing,stasis-removing and detoxification,warming the

关 键 词：结肠癌 脾胃元气 健脾清肠解毒 毒证 扶正祛邪 医案 陆拯 名中医经验 

分 类 号：R574[医药卫生—消化系统]