基于“阳浮而阴弱”运用当归六黄汤治疗癌症术后多汗

Discussion on the use of Danggui Liuhuang Decoction (Chinese Angelica Six Yellow Decoction) for treating postoperative hyperhidrosis in cancer patients based on the theory of "yang floating and yin weakness"

多汗症是指躯体出汗超出体温调节需求,导致全身或局部出汗过多的综合征,在中医学属“汗证”范畴。癌症术后患者邪实骤去、正气内虚,具有虚而不谐的特点,此时多汗者为“阳浮而阴弱”。阳虚而浮,阴虚而弱,亦属营卫不和。阴阳俱虚,在里之阴不内守,在外之阳虚而外散。且虚人更易外感,每伤于风则卫阳更弱而反欲作强,则见身热汗漏不止。当归六黄汤所治为阴虚火旺、卫随汗虚之证,与阴阳俱虚证有所契合,区别在于阴虚火旺者卫表因盗汗而虚,而肿瘤术后者本就阴阳俱虚,其汗出为主症者,即“阳浮而阴弱”,阴不能内守,阳虚不能自固,亦合当归六黄汤之义。

Hyperhidrosis is a syndrome in which the body sweats beyond the needs of thermoregulation,resulting in excessive systemic or local sweating.It belongs to"sweating syndrome"in traditional Chinese medicine.After cancer surgery,patients are just divorced from pathogens,and their healthy qi is lacking.At this time,their yin and yang are both weak and lose their balance.People who suffer from hyperhidrosis can be described as"yang floating and yin weakness".Floating yang results from its weakness and yin deficiency leads to its weakness,which also belong to disharmony of ying and wei qi.When yang and yin are both weak,inner yin can not hold yang,and thus outlying yang shall drift away.Besides,weak patients would become awfully vulnerable to exogenous diseases.Their exterior yang would struggle to fight the pathogens only to get sicker,thus causing hyperhidrosis.Danggui Liuhuang Decoction(Chinese Angelica Six Yellow Decoction)can fix the pattern of yin deficiency with effulgent fire and pattern of qi deficiency due to sweat.It also agrees with patten of yin and yang deficiency.However,there is some difference between them.Patients with pattern of yin deficiency with effulgent fire could be weak because of abnormal sweating,while patients after cancer surgeries are characterized by both yin and yang deficiency.Therefore,Danggui Liuhuang Decoction can not only tonify and strengthen yin,but also warm and reinforce exterior yang,and is used in the treatment of postoperative hyperhidrosis in cancer patients with"yang floating and yin weakness".