刘沈林治疗晚期消化道肿瘤用药经验

Liu Shenlin's Experiences in the Medication for Advanced Gastrointestinal Cancer

晚期消化道肿瘤患者失去了根治性手术机会,现代医学治疗主要包括放化疗、靶向治疗、免疫治疗等,但并不能使患者从中获益,反而会进一步损伤机体免疫力,加快病情进展。中医认为晚期消化道肿瘤正气内虚为主,血瘀、癌毒、痰凝、气滞为标,在治疗上强调以健脾益气扶正为主,佐以化瘀解毒、化痰散结,通过正确的辨证、组方用药可以提高机体免疫力,改善生命质量,从而实现带瘤生存,延长生存期。刘沈林教授总结多年消化道肿瘤临床经验,认为晚期消化道肿瘤正气极虚,治疗上不可一味攻邪,以益气扶正兼顾化瘀为基本治则,用药精简,擅用药对,切中病机,病证结合,生黄芪、党参益气扶正,当归、白芍养血柔肝,三棱、莪术活血化瘀,配伍虫类药攻毒散结,临床收效甚佳。

The patients with advanced gastrointestinal cancer have lost their chance for radical surgery and cannot be improved with modern medicine,such as radiochemotherapy,targeted therapy and immunotherapy because those therapies may further damage the body immunity and accelerate the progression of disease. TCM thinks that advanced gastrointestinal cancer is differentiated as the deficiency of anti-pathogenic qi,combined with blood stagnation,toxification,phlegm accumulation and qi stagnation. The treatment emphasizes strengthening the spleen,benefiting qi and supporting the anti-pathogenic qi,assisted with resolving stasis,detoxification,resolving phlegm and masses. The correct case differentiation and herb composition improve body immunity and living quality so thatthe survival quality with cancer is obtained and the survival span is prolonged. Prof. Liu Shenlin believes,in his clinical experiences in the treatment of gastrointestinal tumors for years,that advanced gastrointestinal cancer presents the extreme deficiency of anti-pathogenic qi,the simple elimination of pathogens is not applicable in treatment. The basic treating principle of the disease should be benefiting qi and strengthening the anti-pathogenic qi,assisted with resolving stasis. Prof. Liu is good at using herbsprecisely,prefers to the paired herbs in terms of pathogenesis and in combination of the disease with symptoms. Radix astragali and codonopsispilosula are used for strengthening the anti-pathogenic qi,angelica sinensis and radix paeoniae alba for nourishing blood and softening the liver,rhizome sparganii and curcuma zedoary for activating blood circulation and removing stasis. The medicines in the category of insects and worms are combined. The clinical therapeutic effects are very satisfactory.