刘万里治疗胃癌术后消化不良经验采撷

Clinical Experience of LIU Wanli in Treatment of Dyspepsia after Gastric Cancer Resection

胃癌是一种严重影响健康的疾病,手术是其主要治疗方案,消化不良是胃癌术后常见并发症之一,严重影响患者的术后康复和生活质量。中医治疗胃癌术后消化不良特色明显,近年来中医、中西医结合及中医外治法治疗胃癌术后消化不良的报道较多。刘万里教授认为本病病位在脾胃,乃虚实夹杂之证,脾胃虚损、癌毒留恋是胃癌术后消化不良发病的病机关键,治疗时以补虚抗癌为基本原则,灵活化裁常毅敏教授创制的单刃剑方,以健运脾胃,固本培元;解毒散结,清除羁毒。临证时辨证施治,重视恢复脾胃生理功能,多兼用滋养胃阴或健脾益气之品以正本;患者术后仍处于癌毒易复的病理状态,多加用天龙颗粒增解毒抗癌之效以清源;辅以疏肝理气、消食开胃、通络活血等法。重视舌苔、脉象及二便,配合摄生调养、心理疏导,以期缓解近期症状、延长远期生存及提高生活质量。文章介绍刘万里教授诊治胃癌术后消化不良的临床经验及用药,以期为临床诊治胃癌术后消化不良提供更多的思路及方法。附验案1则。

Gastric cancer is a disease that seriously affects human health,surgery is the main treatment option.Complications are prone to occur after gastric cancer resection,among which dyspepsia is ranking the top,postoperative dyspepsia after gastric cancer seriously affects the patients′postoperative recovery and quality of life.Traditional Chinese medicine has characteristics in the treatment of postoperative dyspepsia after gastric cancer.In recent years,there are many reports on the treatment of postoperative dyspepsia after gastric cancer by traditional Chinese medicine,integrated traditional Chinese and western medicine,and the external treatment of traditional Chinese medicine.Professor LIU Wanli thinks that the disease is located in spleen and stomach.It is a complicated syndrome of deficiency and excess.Deficiency of spleen and stomach and cancer toxin are the key to the pathogenesis of the onset of postoperative dyspepsia after gastric cancer.The treatment should be based on supplementing deficiency and anti-cancer.The principle is to flexibly tailor the single-edged sword prescription created by Professor CHANG Yimin to strengthen spleen and stomach,detoxify,dispel stagnation and remove toxin.The treatment should be according to the syndrome differentiation,pay attention to the restoration of the physiological functions of spleen and stomach,and use the product that nourishes the stomach Yin or invigorate spleen and Qi as the original.The patient is still in a pathological state of cancer and easily reversible after the operation,and Tianlong Granules(天龙颗粒)are used to increase detoxification and anticancer effect.Supplemented by the methods of soothing liver and regulating Qi,dispelling food and appetizing,dredging collaterals and promoting blood circulation,paying attention to tongue coating,pulse condition and stool,cooperated with health regimen and recuperation and psychological counseling,in order to alleviate recent symptoms,prolong long-term survival and improve the quality of life.This article introduced Professor LIU Wanli′s clinical experience and medications in the diagnosis and treatment of dyspepsia after gastric cancer,in order to provide new ideas for the clinical diagnosis and treatment of dyspepsia after gastric cancer.One case was attached.