孙伟正运用清解之法辨治多发性骨髓瘤经验

Professor SUN Weizheng's Experience in Diagnosing and Treating Multiple Myeloma with the Clearing Releasing Therapy

总结孙伟正教授运用清解之法治疗多发性骨髓瘤的临证经验。认为多发性骨髓瘤的病机为肾精虚损、邪毒侵蚀、痰瘀互结,治疗应虚实共参、标本兼顾,并据此提出清解之法。“清”即在补虚扶正时主张以清补之品使补而不衍生他邪,以清热解毒兼祛瘀化痰散结之品清除邪毒;“解”即在“清”的基础上以甘温、辛温之品补益少火,散解凝肉结骨之寒邪。以清解为原则自拟济世饮以补肾固精、祛痰化瘀、解毒散结,随证灵活加减,同时主张多法并用,重视外治法灌肠以通便泻热并提倡针药联合以助止痛。

The article summarized professor SUN Weizheng's clinical experience in treating multiple myeloma using the clearing-releasing therapy.It is believed that the mechanism of multiple myeloma is kidney essence insuffi⁃ciency,pathogenic toxin erosion,and blinding of phlegm and stasis.The treatment should consider both the deficiency and the excess,and the root and branch.Thus,the clearing-releasing therapy is proposed.“Clearing”refers to the approach of supplementing deficiency and reinforcing health while advocating the use of clearing and supplementing products to replenish without generating additional pathogenic factors.Additionally,products that clear heat,resolve toxins,dispel stasis,dissolve phlegm,and eliminate masses is suggested to benefit for clearing away pathogenic toxins.“Releasing”means to replenish the normal yang qi with sweet-warm and acrid-warm products on the basis of“clearing”method,and to release the cold pathogen constraint in the muscles and bones.Based on the principle of clearing and releasing,the selfmade Jishi Beverage(济世饮)is formulated to supplement the kidney and secure essence,dispel phlegm and dissolve stasis,resolve toxins and dissipate masses.The prescription can be modified according to syndrome differentiation.It is also advocated to use multiple methods and pay attention to external therapies such as enema for relieving constipation and draining heat,and to combine acupuncture and medicine to relieve pain.