赵昌林主任医师从肝论治结直肠癌的临床经验

Zhao Changlin's clinical experience in treating colorectal cancer based on liver therapy

赵昌林主任医师对于如何运用中医药治疗恶性肿瘤具有丰富的临床经验。结直肠癌发病率高、致死率高,临床中结直肠癌的中医药治疗多从脾胃论治,多以健脾化痰、祛瘀散结为治则。赵昌林主任医师认为,肝气条达则脏腑气血调和,治疗大肠癌除了调理脾胃,也不能忽视肝的重要作用。通过对肝与结直肠癌之间联系的梳理,并引用“肝通大肠”“开、阖、枢”理论、“五脏别通”理论加以验证,归纳出肝与大肠在经络、生理、病理上关系密切、相互作用,肝的功能失常是结直肠癌发生的重要病理基础。肝失疏泄直接影响大肠的功能,并通过对脾胃气机、胆汁分泌、精神情志的影响使其传导失司,在气滞基础上产生痰湿、瘀血、热毒等病理产物并蓄积于肠道,发为大肠癌。赵昌林主任医师以肝为中心,从调和肝胆气机出发,结合胆、脾、胃相关脏腑,分析认为结直肠癌的证型可分为肝气郁结、肝肾阴虚、痰湿中阻、肝气亏虚四个证型,选用相应方药治疗,通过相关病例证实这一理论观点所取得的明显临床疗效,并对肠梗阻、肝转移两个结直肠癌常见并发症的中医药治疗进行简述。

Zhao Changlin has rich clinical experience in how to use traditional Chinese medicine to treat malignant tumor.The incidence and the death rate of colorectal cancer is high.The treatment of traditional Chinese medicine in clinical colorectal cancer is mostly from spleen and stomach,usually,to invigorate spleen and remove phlegm,remove blood stasis and disperse knot as the treatment principle.Zhao Changlin believes that only when the liver Qi is unimpeded can the Qi and blood of the human organs become harmonious.In addition to regulating the spleen and stomach,the important role of the liver in treatment of colorectal cancer can't be ignored.By combing the connection between liver and colorectal cancer,citing the theories of"liver connects large intestine""opening,closing and pivoting"and"five viscera related",it is concluded that liver and large intestine are closely related and interacted in meridians,physiology and pathology.Dysfunction of the liver is an important pathological basis for colorectal cancer.The ill liver has directly impact on large intestine,at the same time doing harm to the spleen and stomach Qi,bile secretion,spiritual feelings,drawing to production of phlegm,blood stasis,heat toxin and other pathological products which finally accumulated in the intestinal tract and leading to the occurrence of colorectal cancer.The chief physician Zhao Changlin takes the liver as center,starts from the Qi of liver and gallbladder in addition to contacting the gallbladder,spleen and stomach,analyzes that the syndrome type of colorectal cancer can be divided into four syndrome types:liver Qi stagnation,liver and kidney yin deficiency,phlegm dampness and deficiency of liver Qi.He chooses the corresponding prescription,using the relevant cases to confirm the obvious clinical effect of this theory and traditional Chinese medicine treatment for two complications of colorectal cancer,intestinal obstruction and liver metastasis are briefly described.