基于“治胰从脾”理论谈胰腺癌辨治思路

Discussion on Differentiation and Treatment of Pancreatic Cancer Based on"Treating the Pancrease from the Spleen"Theory

考镜“治胰从脾”源流,并基于胰腺癌“失精浊变”病机,提出正虚邪盛状态下“失精浊变”是胰腺癌发生发展的核心病机所在。中土受损,水谷精微难化,湿浊内生,是为脾精不充;继而浊毒盘踞,耗夺脾精,息而成积,发为脾精不摄;气化不利,郁而化热,湿热毒交阻,积而成癌,癌毒根结,穿孔透里,进而脾精消烁;癌瘤日久,脾精耗竭,机体形气衰败,终成虚劳难复之证。借鉴名家临证经验,阐释“脾精内充”“脾精上奉”“脾精四布”在遣方用药方面的指导意义。

Based on the origin of"treating the pancreas from the spleen"and the pathogenesis of"losing essence and turbidity"of pancreatic cancer,it is proposed that"losing essence and turbidity"is the core pathogenesis of the occurrence and development of pancreatic cancer in the state of excess of pathogens and deficiency of vital energy.It is believed that due to the damage of the center-earth,the essence of water and grains was difficult to dissolve,and dampness and turbidity were generated internally,resulting in insufficient of spleen essence.Then the turbid toxin was entrenched,the spleen essence was consumed,and the rest was accumulated,resulting in the inability of absorb spleen essence.Inhibited Qi transformation,depression turned into heat,dampness and heat were blocked by toxin,which accumulated into cancer,cancer toxin root nodules,perforation through the interior,and then the spleen essence disappeard.Cancer lasted for a long time,the spleen essence was exhausted,the body's form and Qi were weakened,and eventually it became a syndrome of deficiency and exhaustion that was difficult to recover.This article elaborated on the guiding significance of"spleen essence filling","spleen essence ascending",and"spleen essence dispersed throughout the body"in the prescription and medication by referring to the clinical experience of famous experts.