刘沈林教授运用乌梅丸治疗胆管癌的经验  

Professor LIU Shenlin’s experience in treating cholangiocarcinoma with Wumei Wan

作　　者：何亚萍 侯敏艳 彭海燕[2] HE Yaping

机构地区：[1]南京中医药大学,江苏南京210029 [2]南京中医药大学附属医院,江苏南京210029

出　　处：《中医临床研究》2024年第34期110-114,共5页Clinical Journal Of Chinese Medicine

基　　金：江苏省自然科学基金项目(BK20201400);江苏高校优势学科建设工程资助项目(苏政办发[2018]87号)。

摘　　要：胆管癌是指来源于胆管上皮的恶性肿瘤,发病隐匿,患者就诊时多属进展期或晚期,手术治愈率极低,放化疗、靶向治疗效果差。首届全国名中医刘沈林教授总结出一套行之有效的系统性的中医疗法,用于治疗胆管癌。基于胆管的生理和病理特点,结合近50年的临床经验,刘教授将胆管癌的病机特点归纳为本虚标实、寒热错杂,认为胆管癌病位在厥阴经,与少阳经、少阴经关系密切,指出乌梅丸具有交通阴阳、疏通经络气血之功。刘教授临床对于胆管癌证属厥阴病寒热错杂、阴阳失和者运用乌梅丸单方加减,证属少阳经气不利、气机失调者配合柴胡剂,证属少阴伏邪、耗精伤本者配合黄连阿胶汤等方加减用药,治法上主张清泻邪热之余顾护气阴,标本同治,体现了维护人体阴阳平衡、升降有序的治疗理念。Cholangiocarcinoma is a malignant tumor originating from the bile duct epithelium with insidious onset.Most patients are in advanced or late stage when they seek treatment.The cure rate of surgery is extremely low,and the effects of radiotherapy,chemotherapy and targeted therapy are poor.Professor LIU Shenlin,one of the first national famous traditional Chinese medicine doctors,has summarized an effective and systematic TCM therapy for the diagnosis and treatment of cholangiocarcinoma.Based on the physiological and pathological characteristics of the bile duct,combined with nearly 50 years of clinical experience,Professor LIU Shenlin has summarized the pathogenesis of cholangiocarcinoma as deficiency in the origin and excess in syndromes,and simultaneous occurrence of cold and heat,and believes that cholangiocarcinoma is located in Jueyin meridian(厥阴经),and is closely related to Shaoyang meridian(少阳经)and Shaoyin meridian(少阴经).Professor LIU Shenlin points out that Wumei Wan(乌梅丸)has the functions of balancing Yin(阴)and Yang(阳),and unblocking Qi(气)and blood of meridians.In clinical treatment of cholangiocarcinoma,for patients with Jueyin disease with mixed cold and heat,as well as Yin and Yang disharmony,Wumei Wan is used as single prescription by the professor;for patients with Shaoyang meridian Qi dysfuntion,Wumei Wan plus the decoction composed of Chaihu(Radix Bupleuri)is used by the professor;for Shaoyin syndrome patients with consumption and injury of essence caused by latent pathogenic factors,the addition and subtraction of Wumei Wan plus the Huanglian Ejiao decoction(黄连阿胶汤)and others are used by the professor.In terms of treatment method,it is advocated to protect Qi and Yin while clear away pathogenic heat,thereby treating the superficial symptoms and root causes simultaneously,which reflects the treatment concept of maintaining the balance of Yin and Yang,and the order of ascending and descending in the human body.

关 键 词：胆管癌 乌梅丸 名医经验 

分 类 号：R273[医药卫生—中西医结合]