从“风气通于肝”分期辨治原发性肝癌

Stage Differentiation and Treatment of Primary Liver Cancer from“Wind Qi Communicating with Liver”

肝脏在五行中属木,风生木,有“风气通于肝”之说。肝与风气在生理上相通,病理上相关。风生木,肝属东方木,春应肝,肝受春气的滋养,正常的风气有升发之性,万物得之则生机蓬勃,故肝与风气在生理上相通。风气可以养肝,然风气太过与不及皆可伤肝,而为风邪。肝为风木之脏,肝藏血属阴为体,肝气疏泄属阳为用,体阴而用阳,易升易动,与风性相类,一则易受外风侵袭,二则风气内动而患病,故肝与风气在病理上相关。通过对“风气通于肝”理论的阐述,认为风邪伴随原发性肝癌发生发展的整个过程,与原发性肝癌同类相感、同气相求,则风药药和而易入,故对原发性肝癌分期辨治。肝癌形成前期以邪实为主,治以祛除外风;肝癌形成期肿瘤尚未发生转移,注重攻邪,以搜风剔络、化瘀解毒为治则,同时应警惕肝病传脾,兼顾脾胃,以减少病传他脏的机会;肝癌复发转移期注重扶正祛邪,以滋补肝肾、柔肝息风为主;肝癌恶病质期机体失荣,治以暖肝息风。

Liver pertains to wood in the five elements.Wind generates wood,so it is said“wind qi communicating with liver”.Liver and wind qi are physiologically connected and pathologically related.Wind generates wood,liver belongs to wood in east,spring correlates to liver,and liver is nourished by spring qi.The normal wind qi has the nature of rise and dispersion,supporting all things with full of vitality,so liver and wind qi are physiologically connected.Wind qi can nourish liver,but too much or insufficient wind qi can hurt liver,and may become wind pathogen.Liver is the organ of wind wood,the blood stored in liver belonging to yin as the body,and liver qi in charge of free flow belonging to yang as the function.Yin in property and yang in function of liver,which is easy to rise and move,resembling the nature of wind.On the one hand,it is easy to be invaded by external wind,and on the other hand,the disease is caused by wind qi stirring internally.So the liver and wind are pathologically related.Through the elaboration of the theory of“wind qi communicating with liver”,it is considered that wind pathogen is accompanied by the whole process of the occurrence and development of primary liver cancer,which is similar to primary liver cancer,so wind medicine is easy to enter.Primary liver cancer is treated by staging.In the early formative stage of liver cancer,mainly with excess pathogen,the main treatment is to expel exogenous wind.The liver cancer in the formative stage has not yet metastasized,we should pay attention to purge pathogen,and take expelling wind from collaterals,resolving blood stasis and removing toxin as the treatment principle.At the same time,we should be vigilant about liver disease transmitting to spleen and give consideration to spleen and stomach,so as to reduce the chance of disease transmitting to other organs.In the period of recurrence and metastasis of liver cancer,we should pay attention to reinforcing healthy qi and expelling pathogen,mainly nourishing liver and kidney,softening liver and extinguishing wind.In the cachexia stage of liver cancer,the body loses its nourishment,and the treatment is to warm liver and extinguish wind.