中医药治疗胃癌呕吐的基本原则

Basic Principles of Gastric Vomiting With Chinese Medicine Treatments

胃癌进展期(中晚期)常表现为上腹部疼痛,消化道出血,穿孔,幽门梗阻,呕吐等相应症状。而呕吐症状是胃癌较为常见的症状之一,常常导致患者消瘦,乏力,代谢障碍等。初起患者仅有食后不适,饱胀及轻度恶心感,但是随着病程的进展,肿瘤引起的梗阻及胃功能絮乱的症状日渐加重。同时,贲门部癌可导致幽门梗塞进而可出现频繁呕吐,吐前疼痛,吐后疼痛缓解,呕吐物中有食糜,并有腐败臭味。呕吐前常出现上腹胀满疼痛,吐后胀痛有所缓解。中医理论认为脾胃虚弱,痰毒瘀结使中焦运化不利,气机絮乱,最终出现呕吐等症状[1]。疾病初起可见食少嗳气,呕吐时作,隐隐作痛。继之,气滞血瘀,脉络失和,则见呕血;久之痰瘀互结,或郁热伤阴,则呕血鲜红;痰浊内聚,则呕吐痰涎;病程迁延,则以气血双亏为主,呕吐无力,多为干呕。

Gastric cancer in advanced stage often appears abdominal pain,gastrointestinal hemorrhage,perforation,obstruction of the pylorus,vomiting and other accompanying symptoms.And vomiting is the more common symptom of gastric cancer,which results in weight loss,weakness,and metabolic disorders and so on.At beginning,there is only discomfort after eating,fullness and mild nausea,but as the disease progresses,tumor-induced obstruction and gastric functional disorder symptoms become aggravated day by day.Meanwhile,carcinoma of the gastric cardia and pylorus infarction can cause frequent vomiting,which appears that vomiting after pain,pain relief after vomiting,vomiting with chyme,and corruption.Vomiting usually occurs before epigastric distention pain,and after vomiting the pain gets eased.Chinese medicine theory believes that the weakness of the spleen and stomach as well as phlegm stagnancy can lead to adverse Qi disorder,and eventually vomiting.In early stage,less intake of food,belching,vomiting,aching are the manifestations.Afterwards,qi stagnation and blood stasis,disharmony of collaterals can cause hematemesis.A long time later,phlegm and blood stasis or stagnated heat damageing Yin could lead to vomiting red blood.Phlegm and turbidity internal accumulation could lead to vomiting phlegm.The prolonged course is characterized with deficiency of both Qi and blood,weak vomiting,and retching.