王笑民基于命元三焦膜原理论探讨恶性胸腔积液治疗思路

Wang Xiaomin's discussion on the treatment of malignant pleural effusion based on the theory of mingmen,sanjiao and membrane

总结基于命元三焦膜原理论探讨恶性胸腔积液的治疗思路。生理情况下,命门内蕴元阴元阳,三焦敷布元阴元阳,膜原为脏腑之间的空腔间隙,沟通表里内外;病理情况下,癌毒内生,暗耗真阴,相火亢盛,精血暗耗则大肉尽脱、虚火灼肺;阴损及阳,元阳式微,肾虚气逆,发为虚喘。元气亏虚,三焦失养,津液凝血蕴结胸膜膜原则发为恶性胸腔积液。是以命元亏虚、肾虚气逆为本,三焦膜原不利为标。治疗上注重峻补真阴为先,不忘引火归原,常用引火汤重用熟地黄;疏利三焦膜原,强调辛燥散邪,方以达原饮加味。标本同治,疗效确切。

This article summarizes the treatment of malignant pleural effusion based on the theory of mingmen,sanjiao and membrane.Physiologically,mingmen(GV4)fosters primordial yin and yang,while sanjiao disperses them,and membrane is the space between the zang fu viscera,which controls the qi communication between superficies and the interior.Pathologically,the endogenous cancer toxin depletes primordial yin unnoticeably,leading to an exuberance of ministerial fire,a flesh loss and deficient fire burning the lungs.The yin deficiency involves yang,resulting in a declination of primordial yang,a reversed flow of qi due to lung deficiency and developing into deficient dyspnea.The exhaustion of primordial qi leads to a malnutrition of sanjiao,resulting in accumulated fluids and blood coagulation in the pleural membrane and finally developing into malignant pleural effusion.Accordingly,the root cause of the disease lies in the exhaustion of mingmen primordial qi and the counter flow of qi due to lung deficiency,while its manifestation features the malfunction of sanjiao and membranes.Therefore,its treatment prioritizes tonifying drastically primordial yin,directing deficient fire to a normal state,which is often achieved by choosing Yinhuo decoction and applying prepared rehmannia root in a large dosage.Secondly,it is necessary to dredge and activate sanjiao and membrane by using drugs of pungent and dry natures to dispel pathogens,and modified Dayuan Yin is often preferred.The proposed method can achieve the goals of treating both manifestations and the root cause of the disease,having a definite therapeutic effect.