刘沈林教授辨治中晚期胃癌的经验探析

Professor Liu Shenlin’s experience in treating advanced gastric cancer

胃癌是消化道常见恶性肿瘤之一,在我国发病率及病死率均较高,因早期难以发现,多数确诊时已属中晚期,而中晚期胃癌治疗疗效不佳,易进展复发,生存时间短。全国名中医刘沈林教授善治脾胃病,尤其对于中晚期胃癌的治疗,有独到的见解。刘沈林教授认为中晚期胃癌患者多因正气不足,癌毒侵袭,脾胃虚弱,运化失司,气虚则血瘀,日久瘀毒互结所致。因此刘师提出中晚期胃癌病机为脾虚瘀毒,治疗以益气健脾、化瘀解毒为基本法则。另外,在遵循病机设立大法的基础上,临床辨治从脏腑辨证着手,与八纲辨证相结合,强调整体论治,注重药物性味归经,选药斟酌,用药精当,临床疗效显著。本文简介刘师临证辨治中晚期胃癌经验,以飨同道,并附验案1则以证之。

Gastric cancer is one of the common malignant tumors of the digestive tract,with a high incidence and fatality rate in China.Since it is difficult to be detected at early stages,most of the cases are already in the advanced stage when the diagnosis is made.However,the therapeutic effect for advanced gastric cancer is usually poor,and it is easy to progress and relapse,and the survival time is short.Prof.Liu Shenlin,laureate of the title of National Prestigious TCM doctor,is good at the treatment of spleen and stomach diseases,and has unique views on the treatment of advanced gastric cancer.He believes that advanced gastric cancer is mostly caused by lack of healthy qi enabling invasion of cancerous toxin,and weakness of the spleen and stomach leading to the loss of their function of controlling transportation and transformation,so that qi deficiency causes blood stasis.With time going by,the blood stasis and cancerous toxin bind with each other and give rise to the cancer.Hence,Prof.Liu proposed that,for advanced gastric cancer,the pathomechanism of which is spleen deficiency and stasis toxin,it is necessary to adopt the method of boosting qi and fortifying the spleen,dissolving stasis and removing toxin as the basic treatment principle.In addition,after the fundamental idea of treatment is decided based on pathogenesis,clinical differentiation and treatment should then start from the syndrome differentiation of zang-fu organs,combined with the syndrome differentiation of eight principles,emphasizing the holistic treatment,paying attention to the properties,tastes,and channel tropism of herbal ingredients,selecting drugs appropriately,using drugs carefully,so as to guarantee significant clinical efficacy.In this paper,we introduce Prof.Liu’s experience in the treatment of advanced gastric cancer in combination with a clinical case record.