从“痰”分阶段论治食管癌

Treating Esophageal Cancer in Stages from Perspective of"Phlegm"

痰的形成,是食管癌产生的主要病因。食管癌气滞血瘀热结等病机均由痰所起。五脏皆可生痰,但食管癌的论治中以脾脏最为关键。食管癌初期,正虚较轻,加之病程较短,“痰”邪郁积时间较短,属有形之邪,阻滞气机,故食管癌初期,可辨为痰气交阻证;病至中期,痰气郁结日久,“痰”“气”“瘀”三者胶结,形成痰瘀互结证;病至后期,络脉瘀阻,则生内热,热邪耗气伤阴,形成津亏热结证;病入末期,血脉俱耗,胃脘亦槁,气血损耗过度,则可损伤阴阳之根本,形成阳虚痰郁证。

The formation of Phlegm is the main cause of esophageal cancer,the pathogenesis of which such as stagnation of Qi,blood stasis and Heat accumulation are all caused by Phlegm.Each of Wu Zang can produce Phlegm,but Spleen is the most important Zang in treatment of esophageal cancer.In the early stage of esophageal cancer,the deficiency of Zheng Qi is mild,the course of the disease is shorter,and"Phlegm"accumulates for a short time.In the middle of the illness,the stagnation of Phlegm and Qi persists for a long time,and the three of"Phlegm","Qi"and"stasis"are cemented with one another,forming a syndrome of mixed Phlegm and stasis.In the later stage of the disease,when the collaterals are blocked,the internal Heat is generated,and the Heat evil consumes Qi and injures Yin,forming a syndrome of body fluid deficiency and Heat.In the terminal stage of the disease,the blood vessels are exhausted,the gastric cavity is also chaotic,and the Qi and blood loss is excessive,which can damage the root of Yin and Yang,forming a syndrome of Yang deficiency and Phlegm depression.