张磊从“痰核”论治胃息肉经验

Professor ZHANG Lei′s Experience in Treating Gastric Polyps from the Perspective of “Phlegm Node”

介绍张磊教授从"痰核"论治胃息肉的经验。认为胃息肉在病症特点、基本病机等方面与中医学中"痰核"相符,胃生痰核,发为息肉为胃息肉的病症特点;痰湿结聚,痰凝为核为胃息肉的基本病机。以化痰散结为治则,治疗上据气滞、血瘀偏重的不同以及积聚的轻重,选用理气化痰、活血化痰、软坚散结等方法治疗GP。理气化痰,解郁和胃,开郁结,疏壅滞,常选用越鞠丸化裁;活血化痰,涤浊消癥,以加味二陈汤化裁;软坚化痰,散结平胬,选用攻坚破积之品,以济生乌梅丸化裁。

This paper summarized Professor ZHANG Lei′s experience in treating gastric polyps from "phlegm node". It is believed that the pathological characteristics and disease mechanism of gastric polyps are consistent with the "phlegm node" in traditional Chinese medicine. Phlegm node in stomach develops into the polyps formulating the symptoms of gastric polyps;phlegm-damp accumulation and phlegm coagulation into nuclei are the basic pathogenesis. Following the principle of dissolving phlegm and dissipating masses, the treatment should be differentiated regarding the types of qi stagnation and blood stasis as well as the degree of accumulation, and accordingly, the methods of regulating qi to dissolve phlegm, invigorating blood to dissolve phlegm, and softening hardness to dissipate masses can be used. To regulate qi and resolve phlegm, resolve constraint and harmonize stomach, remove accumulation and dredge congestion, modified Yueju Pills(越鞠丸) is often used;to invigorate blood and resolve phlegm, remove turbidity and reduce concretions, modified Erchen Decoction(二陈汤) is recommended;to soften hardness and resolve phlegm, dissipate masses and heal wound, modified Jisheng Wumei Pills(济生乌梅丸) with the function of purging hardness and breaking up accumulations can be chosen.