基于复法大方思想辨治癌性腹水经验撷菁  

Clinical experience in treating malignant ascites based on the thought of compound prescriptions

作　　者：王颖睿 王金秋 王泽坤 桑天庆 焦鹏飞[4] 郑玉玲 WANG Yingrui;WANG Jinqiu;WANG Zekun;SANG Tianqing;JIAO Pengfei;ZHENG Yuling(Department of Hematology and Oncology,The First Affiliated Hospital of Henan University of CM,Zhengzhou 450003,China;The First Clinical College of Henan University of Chinese Medicine,Zhengzhou 450046,China;Department of Traditional Chinese Medicine,Zhengzhou People’s Hospital,the Fifth Clinical College of Henan University of Chinese Medicine,Zhengzhou 450003,China;Respiratory Department,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450003,China)

机构地区：[1]河南中医药大学第一附属医院血液肿瘤科,郑州450003 [2]河南中医药大学第一临床医学院,郑州450046 [3]河南中医药大学第五临床医学院,郑州人民医院中医科,郑州450003 [4]郑州大学第一附属医院呼吸内科,郑州450003

出　　处：《中华中医药杂志》2025年第1期235-238,共4页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：全国名老中医药专家传承工作室建设项目(No.国中医药人教函[2022]75号);全国名中医传承工作室建设项目(No.国中医药办人教函[2022]245号);河南省中医药科学研究专项课题(No.2019JDZX2073)。

摘　　要：癌性腹水多见于腹盆腔恶性肿瘤晚期,现代医学手段总体疗效有限。郑玉玲教授提出癌性腹水的形成同时兼有水停、气滞、瘀阻、癌毒、阳虚5种病理因素,明确癌性腹水的病机为气滞瘀阻、阳虚水停、癌毒泛行。单方单法,较难抑制腹水增加、改善症状、延长患者生存时间。故基于复法大方思想,通过合小方、助君药、增用量自拟扶正消水汤,利水、行气、化瘀、祛毒、温阳五法并用,经方时方相得,辨证选药益彰,辨治癌性腹水。大方大量,扶正为先,利水为主,消瘤为辅,同时兼顾恶性腹水常见兼症加减化裁,疗效确切。Malignant Ascites is mostly seen in the late stage of abdominal and pelvic malignant tumors,and the overall curative effect of modern medical means is limited.Professor ZHENG Yuling proposed that the formation of malignant ascites is combined with five pathologic factors,including water stagnation,qi stagnation,blood stasis,cancer toxin,and yang deficiency.It was clear that the pathogenesis of malignant ascites was qi stagnation and blood stasis,yang deficiency,water stagnation,and cancer toxin.It is difficult to inhibit the increase of ascites,improve symptoms and prolong the survival time of patients with single prescription and single method.Therefore,based on the Thought of compound prescriptions,the Fuzheng Xiaoshui Decoction is formulated by combining small prescriptions,drugs to help the monarch,and increasing the dosage.The five methods of promoting water,promoting qi,removing blood stasis,removing toxin,and warming yang are used together.The classic prescriptions are obtained according to the time,and the drugs are selected according to the syndrome differentiation,so as to treat cancerous ascites according to the syndrome differentiation.It is generous and massive,with strengthening the body first,diuresis first,and tumor elimination as a supplement.At the same time,it also takes into account the common complications of malignant ascites,plus or minus the cutting,and the curative effect is accurate.

关 键 词：复法大方思想 恶性腹水 扶正消水汤 名医经验 郑玉玲 

分 类 号：R273[医药卫生—中西医结合]