吴煜运用补中益气汤合二陈汤加减治疗癌痛

WU Yu Uses Buzhong Yiqi Decoction(补中益气汤)and Erchen Decoction(二陈汤)to Treat Cancer Pain

补中益气汤出自金元时期著名医家李东垣的《脾胃论》,主治脾气虚弱证诸症;二陈汤出自宋代《太平惠民和剂局方》,主治痰湿阻滞证诸症。两方均是中医上有名且临床常用的方剂,亦是通过现代临床研究证明具有抗肿瘤的作用。癌性疼痛(以下简称癌痛)是晚期肿瘤患者常见且难以忍受的并发症之一,常影响患者的生活质量及治疗。吴煜教授认为癌痛在中医上证属正虚邪实,脾气亏虚、痰湿凝滞为癌痛的基本病机,补中益气汤合二陈汤,一方面可以健脾助运以养正虚而补气血不足,另一方面可化痰除湿助气血运行以达气血通畅,二者合用可达到健脾化痰、祛湿止痛之效。另外,可随症加减,如辨证有瘀加活血药,辨证气滞加理气药,合并热邪加清热药,若有肾虚加补肾药等等。故吴煜教授临床上辨证运用补中益气汤合二陈汤加减治疗癌性疼痛疗效显著。该文通过案例举例的方法,例举3个案例,简述吴煜教授运用补中益气汤合二陈汤加减治疗肝癌癌痛、大肠癌癌痛以及肺癌癌痛的经验。

Buzhong Yiqi Decoction(补中益气汤)is derived from the Theory of Spleen and Stomach by LI Dongyuan,a famous doctor in the Jin and Yuan Dynasties.It is mainly used to treat various diseases of spleen Qi deficiency syndrome.Erchen Decoction(二陈汤)is derived from Taiping Huimin Heji Formula of Song Dynasty,which is mainly used to treat various symptoms of phlegm-dampness block syndrome.Both prescriptions are famous in traditional Chinese medicine and commonly used in clinic.They also have been proved to have anti-tumor effect through modern clinical research.Cancer pain is one of the common and unbearable complications in patients with advanced cancer,which often affects the quality of life and treatment of patients.Professor WU Yu believes that cancer pain in traditional Chinese medicine belongs to root deficiency and evil excess.Deficiency of spleen Qi and stagnation of phlegm-dampness are the basic pathogenesis of cancer pain.Buzhong Yiqi Decoction combined with Erchen Decoction can strengthen the spleen and help the movement to nourish the deficiency of Qi and blood on the one hand.On the other hand,it can remove phlegm and dampness and help the movement of Qi and blood to achieve the smooth flow of Qi and blood.The combination of the two can achieve the effects of strengthening spleen,resolving phlegm,removing dampness and relieving pain.In addition,it can be added or subtracted with symptoms.When there is blood stasis,we can add blood-activating drugs.When there is Qi stagnation,we can add Qi-regulating drugs.Heat-clearing drugs can be added for heat evil and kidney-tonifying drugs can be added for kidney deficiency.Therefore,Professor WU Yu's clinical application of Buzhong Yiqi Decoction combined with Erchen Decoction is effective in the treatment of cancer pain.This paper briefly described professor WU Yu's experience in the treatment of liver cancer pain,colorectal cancer pain and lung cancer pain by using Buzhong Yiqi Decoction and Erchen decoction.