周红运用“三辨模式”治疗原发性肝癌经验
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摘要
"三辨模式"即"辨病-辨体-辨证"相结合的诊疗模式,其中辨病主要是辨病因、病位。肝癌多因肝气郁结或湿毒之邪阻遏肝脏,气机升降出入失常,木欲条达而不能,肝脏阴阳失调,横犯中焦脾胃,气血调摄失常,导致气血瘀滞、水液不化,久则逐渐形成顽痰、死血,正虚而不能奋起抗之,顽痰、死血积久不去,化火成"毒",发为肝癌,病位在肝,与脾、肾相关。辨体是掌握患者体质特点,抓住疾病本质,提高辨证的准确度,且体质差异决定了个体对药物的耐受性和反应性的不同,体质辨证是指导临床组方用药的重要依据。辨证就是抓主证的过程,主证是反应机体主要矛盾的具体表现,是疾病实时地表现机体的阴阳失衡状态,通过抓主证推理出疾病最内在的机制,以确立方证关系,达到辨证论治的目的。
The three-differentiation model,namely,the diagnosis and treatment model of disease differentiation,constitution differentiation and syndrome differentiation in combination.Among them,disease differentiation means to distinguish the cause and the location of the disease.Liver cancer is often caused by liver Qi stagnation or Damp poisoning,which inhibits the normal movement of Liver Qi.Then there is the imbalance between the Liver Yin and Yang,which would to the dysfunction of Spleen and Stomach as well as the imbalance of Qi and Blood,resulting in the stagnant Blood and Water within body.After a long time,stubborn and death Blood would come into being gradually and then they would turn into "poisonous" factors and Liver cancer is caused.The disease was in the liver,be related to the Spleen and Kidney.Constitution differentiation is to work out the patient′s physical characteristics and to grasp the nature of the disease,so as to improve the accuracy of syndrome differentiation.Besides,the difference in physical constitution determines the individual′s tolerance to drugs and the difference in reactivity.Therefore,physical and syndrome differentiation is an important basis for clinical prescriptions.Syndrome differentiation is the process of grasping the main syndrome,which is the specific manifestation of the main contradiction of Yin and Yang in the body.It is the disease that expresses the yin and yang imbalance in the body in real time.By grasping the main syndrome,the most intrinsic mechanism of the disease is to be found out and the correct relationship between the prescription and the syndrome is to be established.Eventually,the purpose of syndrome differentiation is to be achieved.
The three-differentiation model,namely,the diagnosis and treatment model of disease differentiation,constitution differentiation and syndrome differentiation in combination.Among them,disease differentiation means to distinguish the cause and the location of the disease.Liver cancer is often caused by liver Qi stagnation or Damp poisoning,which inhibits the normal movement of Liver Qi.Then there is the imbalance between the Liver Yin and Yang,which would to the dysfunction of Spleen and Stomach as well as the imbalance of Qi and Blood,resulting in the stagnant Blood and Water within body.After a long time,stubborn and death Blood would come into being gradually and then they would turn into "poisonous" factors and Liver cancer is caused.The disease was in the liver,be related to the Spleen and Kidney.Constitution differentiation is to work out the patient′s physical characteristics and to grasp the nature of the disease,so as to improve the accuracy of syndrome differentiation.Besides,the difference in physical constitution determines the individual′s tolerance to drugs and the difference in reactivity.Therefore,physical and syndrome differentiation is an important basis for clinical prescriptions.Syndrome differentiation is the process of grasping the main syndrome,which is the specific manifestation of the main contradiction of Yin and Yang in the body.It is the disease that expresses the yin and yang imbalance in the body in real time.By grasping the main syndrome,the most intrinsic mechanism of the disease is to be found out and the correct relationship between the prescription and the syndrome is to be established.Eventually,the purpose of syndrome differentiation is to be achieved.
引文
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[6]申荣旻,张妍,王济,等.辨体—辨病—辨证诊疗模式在针灸治疗过敏性疾病中的应用[J].中医杂志,2015,61(4):289-292.
[7]王颖,郝松莉,孙淼,等.辨体、辨病、辨证诊疗模式在妇科疾病中的应用探析[J].中医杂志,2013,59(14):1246-1247.
[8]乔德峰,范彦荣,赵刘乐,等.辨体、辨病、辨证诊疗模式下针刺治疗抑郁症160例[J].河南中医,2017,37(4):624-627.
[9]周计春,邢风举,颜新.国医大师周仲瑛教授治疗癌毒五法及辨病应用经验[J].中华中医药杂志,2014,29(4):1112-1114.
[10]蔡小平,魏征.恶性肿瘤中医证治新理论——瘀毒论[J].辽宁中医杂志,2013,55(3):465-466.
[11]许鑫,郑伟鸿,郑东海,等.慈丹胶囊治疗原发性肝癌150例临床观察[J].世界中医药,2011,6(6):469-470.
[12]张玉军,胡同春,王玉强.中药组方联合化疗治疗中晚期原发性肝癌的临床研究[J].中国药物与临床,2012,12(4):474-475.
[13]崔艳东.扶正抗癌方治疗原发性肝癌39例临床疗效观察[J].河南中医,2013,33(1):58-59.
[14]商红叶,郭卉,张文涛.TACE术联合中药汤剂治疗原发性肝癌的临床观察[J].内蒙古中医药,2014,33(23):36-38.
[15]白广德,吴洁.康艾注射液联合射波刀方案治疗25例原发性肝癌临床观察[J].新中医,2012,44(3):81-83.
[16]刘雪丽,周学锋,王君瑜,等.中药抗肿瘤作用机制研究进展[J].中国药师,2016,29(6):1158-1162.
[17]陶兰亭,时高波,周红.周红教授治疗咳嗽经验介绍[J].新中医,2011,43(1):154-155.
[2]CHEN W,ZHENG R,BAADE A,et al.Cancer statistics in China,2015[J].Can J Clin,2016,66(2):115-132.
[3]FERLAY J,SOERJOMATARAM I,DIKSHIT R,er al.Cancer incidence and worldwide:sources,methods and major patterns in GLOBCAN 2012[J].Int J Cancer,2015,136(5):359-386.
[4]刘允怡,赖俊雄,刘晓欣.手术切除在肝癌多学科综合治疗中的地位[J].中国实用外科杂志,2014,34(8):677-680.
[5]侯凤刚,凌昌全,沈旭波,等.原发性肝癌中医证型分布文献简析[J].中医杂志,2004,50(11):876-877.
[6]申荣旻,张妍,王济,等.辨体—辨病—辨证诊疗模式在针灸治疗过敏性疾病中的应用[J].中医杂志,2015,61(4):289-292.
[7]王颖,郝松莉,孙淼,等.辨体、辨病、辨证诊疗模式在妇科疾病中的应用探析[J].中医杂志,2013,59(14):1246-1247.
[8]乔德峰,范彦荣,赵刘乐,等.辨体、辨病、辨证诊疗模式下针刺治疗抑郁症160例[J].河南中医,2017,37(4):624-627.
[9]周计春,邢风举,颜新.国医大师周仲瑛教授治疗癌毒五法及辨病应用经验[J].中华中医药杂志,2014,29(4):1112-1114.
[10]蔡小平,魏征.恶性肿瘤中医证治新理论——瘀毒论[J].辽宁中医杂志,2013,55(3):465-466.
[11]许鑫,郑伟鸿,郑东海,等.慈丹胶囊治疗原发性肝癌150例临床观察[J].世界中医药,2011,6(6):469-470.
[12]张玉军,胡同春,王玉强.中药组方联合化疗治疗中晚期原发性肝癌的临床研究[J].中国药物与临床,2012,12(4):474-475.
[13]崔艳东.扶正抗癌方治疗原发性肝癌39例临床疗效观察[J].河南中医,2013,33(1):58-59.
[14]商红叶,郭卉,张文涛.TACE术联合中药汤剂治疗原发性肝癌的临床观察[J].内蒙古中医药,2014,33(23):36-38.
[15]白广德,吴洁.康艾注射液联合射波刀方案治疗25例原发性肝癌临床观察[J].新中医,2012,44(3):81-83.
[16]刘雪丽,周学锋,王君瑜,等.中药抗肿瘤作用机制研究进展[J].中国药师,2016,29(6):1158-1162.
[17]陶兰亭,时高波,周红.周红教授治疗咳嗽经验介绍[J].新中医,2011,43(1):154-155.
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