上病下取法论治食管癌

Application of “treating disease in the upper part of the body by managing the lower” in treatment of esophageal cancer

食管癌无中医病名,依其进行性吞咽困难的主症,可参考中医"噎膈"辨证施治。上病下取法源自《黄帝内经》,是在中医整体观念的指导下,依据人体脏腑、经络及气血运行之间的联系而确立的治则。食管癌病变虽然主要位于人体上部食管,属胃所主,但从脏腑生理病理及经络循行络属角度分析,其病机与下部肝、脾、肾功能失调密切相关。此理论在相关文献书籍及现代研究中也有论述,上病下取法论治食管癌是中医治疗本病的又一思路。

Due to its high morbidity rate and mortality, esophageal cancer remains a common disease in China with heavy burden on society. Although the name of "esophageal cancer" is not clearly recorded in traditional Chinese medicine, its main symptom of progressive dysphagia coincides with the disease of Yege(dysphagia) in TCM, therefore corresponding treatment methods can be referred to. The method of "treating disease in the upper part of the body by managing the lower" was firstly recorded in Huangdi Neijing(Huangdi’s Internal Classic). Under the guidance of the holism concept, this method is built based on the relationship between the viscera, channels and the movement of qi and blood. Although esophageal cancer mainly involves the esophagus in the upper part of the body, its pathogenesis is closely related to dysfunction of the liver, spleen and kidney in the lower part of the body. This theory has also been elaborated on and supported with evidence in related literature and modern researches, so it has the potential to provide new ideas for TCM treatment of esophageal cancer.