陈实功与王维德寒温分治乳岩对比研究

A Comparative Study of CHEN Shigong and WANG Weide in the Treatment of Breast Cancer from the Aspects of Warm and Cold

对明代陈实功《外科正宗》与清代王维德《外科证治全生集》论治乳岩的内容进行梳理,辨析其诊疗特色,比较其学术思想异同。陈实功和王维德都认同情志内伤是乳岩的病因,主张内外并治,认为早治疗预后较好。陈实功认为乳岩病性为火,病机为痰阻气滞,病位主要在肝,主张分期治疗,内用消、托、补,外用灸、针、膏,创清肝解郁汤、益气养荣汤。而王维德认为乳岩病性为寒,病机为阴寒结痰,病位主要在肾,提倡重用消法,慎用托法,忌用刀针,慎用膏贴。他们的认识丰富了中医乳岩诊治体系,对后世产生深远影响。

This article reviews the contents on the treatment of breast cancer in CHEN Shigong's Waike Zhengzong from the Ming Dynasty and WANG Weide's Waike Zhengzhi Quanshengji from the Qing Dynasty,analyzes their clinical characteristics,and compares the similarities and differences in their academic thoughts.Both CHEN Shigong and WANG Weide agree that the seven emotions causing internal damage are the causative factors of breast cancer;they admit that internal and external treatment can be combined;they believe that early treatment leads to better prognosis.CHEN Shigong regards breast cancer as having a heat nature,with a pathogenesis characterized by phlegm Qi stagnation,primarily affecting the liver.He advocates for staged treatment,utilizing reducing,supporting,and tonifying methods internally,alongside external application of moxibustion,acupuncture,and medicated paste,creating formulations such as Qinggan Jieyu decoction and Yiqi Yangrong decoction.Conversely,WANG Weide views breast cancer as having a cold nature,with a pathogenesis characterized by cold phlegm stagnation,primarily affecting the kidneys.He advocates for emphasis on reducing methods,caution with supporting methods,and avoidance of surgical procedures,acupuncture,and medicated pastes.Their understanding enhances the system of traditional Chinese medicine in treating breast cancer,and exerts profound influence on future generations.