蒋士卿教授从六经之厥阴辨治大肠癌经验

Professor Jiang-shiqing's Experience to Treat Carcinoma of Large Intestine by the Differentiation of Symptom Based on Reversal Yin from Six-meridian

蒋士卿教授将大肠癌的理论基础与临床相结合,从六经辨证施治,认为大肠癌属厥阴病,由阴阳气不相顺接所致,临床表现为寒热错杂证,治疗上以寒热并用为基本治疗原则,重用乌梅丸。乌梅丸作为厥阴病的寒热错杂证的主方,集酸苦辛甘、大寒大热之药为一方,具有辛开苦降、寒热并用、补泻兼施、气血两调的特点,正好适合本病的治疗。仲景乌梅丸原方记载:乌梅三百枚,细辛六两,干姜十两,黄连十六两,当归四两,附子六两(炮,去皮),蜀椒四两(出汗),桂枝六两(去皮),人参六两,黄柏六两,上药各为末,合治之。原方中乌梅三百枚为君,以苦酒渍乌梅一宿,去核,蒸之五斗米下,饭熟,捣成泥,和药令相得,以苦酒渍而重用,取其至酸之味、至柔之性,敛肝泻肝,补肝体以制其用。在临床治疗中,要辨证与辨病相结合,在明确疾病诊断的基础上,正确把握病机,辨证施治,选方用药,临床疗效显著。

Professor Jiang Shiqing combines theory and clinic of colorectal cancer of large intestine. From the syndrome differentiation of six-meridian theory,in his opinion,colorectal cancer of large intestine belongs to the symptom of reversal Yin,resulted by disharmony and disorder between Yin and Yang,performed by cold-heat complex in clinic,treated by the combination with cold and heat as the basic principle during clinical course. Wumei Pills,as the principle prescription to treat with cold-heat complex of reversal Yin,should be reuse,which combines with bitter,sweet,acridity,cold and heat in one prescription. It processes the character of opening with acridity and descending with bitter,treatment of the combination with cold and heat,nursing oneself by supplementing Qi and blood,which is suitable for this illness. Wumei Pills recorded by Zhongjing is that 300 grains of Wumei（ Smoked Plum）,Xixin（ Asarum） 6 Liang,Ganjiang（ Rhizoma Zingiberis） 10 Liang,Huanglian（ Coptis Chinensis） 16 Liang,Danggui（Angelica Sinensis）4 Liang,Paofuzi（Processed Monkshood） 6 Liang,Shujiao（Sichuan Peppercorns） 4 Liang,Guizhi（Cassia Twig） 6 Liang（ removing the peel）,Renshen（ Ginseng） 6 Liang,Huangbai（ Cortex Phellodendri） 6 Liang,pressed all of them into powder and complex them to use. Original prescription used 300 grains of smoked plum as the monarch medicine,and dipped in bitter rice wine one night,which means it extracted the tastes of acid,the character of flexibility,astringing and purging the liver,supplementing the liver and restricting its function. During process of clinic,combining the differentiation of syndrome and and disease,based on being clear and definite about diagnosis,grasping the pathogenesis,treating by the differentiation,selecting the prescription and medicine,all of them were effective in clinic.