蔡钢治疗原发性肝癌经验

Cai Gang's Experience of Treating Primary Liver Cancer

原发性肝癌病理本质为本虚标实、虚实夹杂,本虚为肝郁脾虚,肝肾亏虚,标实为湿热瘀毒胶结,积而成形。蔡钢教授治疗原发性肝癌以补虚为主,祛邪为辅,时时顾护胃气。常用茵陈蒿、虎杖、栀子、鸡内金、海金沙、金钱草等疏肝利胆、清热利湿退黄;肝为风木之脏,肝旺则易横犯脾土,蔡教授根据五行生克乘侮规律及五脏关系,重视健脾胃,常用柴胡、枳壳、香附、白术、鸡内金、焦三仙、砂仁、木香等疏肝理气,健脾和胃。其善调补肝肾以扶助正气,常用当归、白芍、五味子、生地黄、玄参、麦冬、川楝子、女贞子、墨旱莲、半枝莲、夏枯草、鳖甲等滋阴补肾、养血柔肝。使用攻伐药物应中病即止,切勿过量,常用莪术、桃仁、海藻、昆布等破血消散结,慎用大剂量破血类药物。且注重心理疏导,常加酸枣仁、柏子仁等养心安神。

The pathological essence of primary liver cancer is the combination of deficiency and excess,with deficiency as primary and excess as secondary.The deficiency as primary is manifested as liver stagnation and spleen deficiency,liver and kidney deficiency,while excess as secondary is manifested as intermingled dampness,heat,blood stasis and toxin,accumulating form.Professor Cai Gang treats primary liver cancer mainly by tonifying deficiency and eliminating pathogenic factors as the auxiliary,and constantly taking care of stomach qi.He often uses Yinchenhao(Herba Artemisiae Scopariae),Huzhang(Rhizoma Polygoni Cuspidati),Zhizi(Fructus Gardeniae),Jineijin(Endothelium Corneum Gigeriae Galli),Haijinsha(Spora Lygodii),Jinqiancao(Herba Lysimachiae),etc.to sooth the liver and promote bile secretion,clearing heat,drain dampness and remove jaundice.Liver belongs to wind wood,and excessive liver fire will easily invade the spleen.According to the laws of the five elements(including mutual generation,mutual restriction,mutual subjugation and reverse restriction,etc.)and the relationship between the five zang-organs,Professor Cai attaches great importance to strengthening the spleen and stomach.He often uses Chaihu(Radix Bupleuri),Zhiqiao(Fructus Aurantii),Xiangfu(Rhizoma Cyperi),Baizhu(Rhizoma Atractylodis Macrocephalae),Jineijin(Endothelium Corneum Gigeriae Galli),Jiaosanxian(Charred Triplet),Sharen(Fructus Amomi),Muxiang(Radix Aucklandiae),etc.to soothe the liver,regulate qi and strengthen the spleen and stomach.He is good at tonifying the liver and kidney to support healthy qi,so he often uses Danggui(Radix Angelicae Sinensis),Baishao(Radix Paeoniae Alba),Wuweizi(Fructus Schisandrae Chinensis),Shengdihuang(Radix Rehmanniae),Xuanshen(Radix Scrophulariae),Maidong(Radix Ophiopogonis),Chuanlianzi(Fructus Toosendan),Nvzhenzi(Fructus Ligustri Lucidi),Mohanlian(Herba Ecliptae),Banzhilian(Herba Scutellariae Barbatae),Xiakucao(Spica Prunellae),Biejia(Carapax Trionycis),etc.to nourish yin and kidney,nourish blood and soften the liver.The use of attacking drugs should stop as soon as they have effects on the disease,and should not be excessive in dosage.So he often uses Ezhu(Rhizoma Curcumae),Taoren(Semen Persicae),Haizao(Sargassum),Kunbu(Thallus Laminariae),etc.to break blood stasis and dissipate mass with proper dosage.He also pays attention to psychological counseling,often adds Suanzaoren(Semen Ziziphi Spinosae),Baiziren(Semen Platycladi),etc.to nourish the heart and calm the mind.