王庆国辨治胆囊息肉样病变经验

Wang Qingguo′s Experience in Differentiation and Treatment of Polypoid Lesions of the Gallbladder

胆囊息肉样病变在临床上可分为活跃增长期、相对稳定期和吸收消散期。活跃增长期是息肉逐渐形成阶段,王教授认为此阶段多为肝气郁滞证,因肝气疏泄失常,气机郁滞,是有形实邪逐渐积聚的阶段;相对稳定期是息肉病理变化趋于稳定的阶段,此阶段由于气机郁滞,痰湿内生,郁而化热,致湿热内蕴,脉络不通,胆气不利,通降失职,病久则瘀血内生,致痰瘀互结,故相对稳定期可分为湿热内蕴证和痰瘀互结证;吸收消散期为疾病向愈的阶段,息肉的病理改变逐渐恢复正常,此阶段相当于中医的邪退正衰期,故此时以肝胆气虚证为主。王师临证注重标本同治,审证求因,固护脾胃,截断病势。

Polypoid lesions of gallbladder can be divided into active growth stage,relatively stable stage and absorption dissipation stage. The active growth stage is the gradual formation stage of polyps. Professor Wang thinks that this stage is mainly the syndrome of stagnation of liver qi. Because of the disorder of liver qi relieving and stagnation of qi mechanism,it is the stage of accumulation of substantial pathogenic factor. The relatively stable stage is the stage of polyp pathological changes tend to be stable,which is due to stagnation of qi and phlegm dampness. Phlegm and dampness stagnate and turn into heat,causing dampness and heat to accumulate,which leads to blocked vein,blocked qi mechanism of gallbladder and loss of its function of descending. The relative stable period can be divided into two types: internal retention of damp-heat syndrome and intermingling of phlegm and static blood syndrome. Absorption and dissipation stage is the stage of disease recovery,and pathological changes of polyps gradually return to normal. This stage is equivalent to the stage of pathogenic regression andvital qi decline of Chinese medicine,so at that time,liver and gallbladder qi deficiency syndrome is the main one. Wang Shilin paid attention to the same treatment of the manifestation and root cause,examined the syndrome and asked for the cause of disease,strengthened the spleen and stomach,and cut off the disease.