王祥麒治疗恶性肿瘤骨转移临床用药特点

Professor Wang Xiangqi′s Clinical Medicating Features in Treating Bone Metastasis of Malignant Tumor

王祥麒教授提出肿瘤骨转移以肾虚为本,肾阴虚是前提,肾阳虚为后发,继而表现为阴阳两虚,肝主筋藏血,肝肾同源,肾精又依赖于肝血的滋养,同时还存在肝血不足的原因。骨失所养,癌邪乘虚而入,留滞骨髓,经络阻塞,聚集成癌。治疗上王教授提出以补肾化痰为主、通络化瘀为辅、止痛贯穿始终。临证用药,常在补肾阴药物的基础上,加入补肾阳药物杜仲,正是效仿阴中求阳之法,常采用熟地黄、杜仲、桑寄生等补肾药物以及化痰散结药物浙贝母、皂角刺、龙骨、牡蛎等。气机不畅是发生瘀血的主要原因,因此将行气化瘀药物蕴于补肾化痰药物之中,如续断、川牛膝、寻骨风、透骨草等。王教授临证还常选用白芍、片姜黄、延胡索等药物,养血柔肝,缓中止痛。

Professor Wang Xiangqi proposed that tumor bone metastasis is Kidney deficiency,with Kidney Yin deficiency is the premise and Kidney Yang deficiency is a posterior condition,which is followed by both Yin and Yang deficiency.Liver governs tendons and blood,and Liver and Kidney are homologue,so Kidney Essence depends on the nourishment of Liver blood.In case of liver blood deficiency,there is a lack of nutrient in bones and then the cancer is taken advantage of that to develop in the bone marrow and to cause the blocked meridians,hence the cancer is integrated.Professor Wang proposes that in treatment tonifying Kidney and dissipating Phlegm should be the main policy,supplementing with dredging collaterals and dispelling stasis to relieve pain.In clinical practice,on the basis of tonifying Kidney Yin drugs,tonifying Kidney Yang drug Eucommia is to applied,which means to follow the method of seeking Yang in the Yin.Besides,drugs like Rehmannia glutinosa,Eucommia,mulberry parasitic and other kidney-reinforcing drugs are often used and drugs Zhejiang Fritillaria,Saponin,Keel,Oysters,etc.to dispel Phlegm and stasis.Abnormal Qi movement is the main cause of blood stasis,so the medicine that can improve Qi movement and dispel stasis are used among the medicine functioning in tonifying Kidney and removing Phlegm,such as Teasel root,Sichuan achyranthes,Berba aristolochiae mollissimae,and Garden balsam Sstem.In Professor Wang′s clinical treatment,drugs such as White peony,Turmeric and Corydalis tuber are also used to nourish the Liver and relieve pain.