基于“传舍”理论与“阳虚毒结”探讨胃癌术后复发转移的防治思路

Ideas for Prevention and Treatment of Postoperative Recurrence and Metastasis of Gastric Cancer Based on the Theory of“Chuan-she”(传舍)and“Yang Deficiency and Toxic Knot”

基于“传舍”理论,阐述阳虚毒结作为核心病机在胃癌术后复发转移各个环节中的作用,并提出聚阳以遏易“传”之势防复发、护阳以安易“舍”之地防转移、温阳以阻“传舍”之途防浸淫、攻伐以清癌毒之邪除宿根的胃癌术后复发转移的防治思路。在防治胃癌术后复发转移的过程中,当以治阳为纲,灵活运用聚阳、护阳、温阳三法;佐以攻伐清除癌毒,辨证与辨病相结合;同时详辨机体虚实寒热变化,随证治之,以期为临床精准辨治胃癌术后复发转移提供借鉴。

Based on the theory of“chuanshe”,this paper expounded the role of yang deficiency and toxic knot as the core pathogenesis in various aspects of gastric cancer recurrence and metastasis after surgery,and put forward the prevention and treatment ideas of recurrence and metastasis of gastric cancer by conjugating yang to curb the trend of“transmission(chuan)”,protecting the yang to prevent metastasis by settling its“residence(she)”,preventing immersion by warming the yang to block the way of“chuan-she”,and attacking and cutting to clear the pathogen of cancer and poison and eliminate the root of the disease.In the process of preventing and treating recurrence and metastasis after gastric cancer surgery,the three methods of conjugating yang,protecting yang and warming yang should be flexibly used based on the principle of treating yang;combined with attacking and removing cancer poison,differentiating syndromes and diseases;meanwhile,the changes of cold and heat in the body should be identified in detail and treated by the syndromes,in order to provide reference for the clinical differentiation and treatment of recur?rence and metastasis after gastric cancer accurately.