中医肿瘤康复中“神不使”病机探析及治则

Pathogenesis Discussion and Therapeutical Principle of“Spirit’s Non-Use”in Tumor Rehabilitation of Traditional Chinese Medicine

“神”是中医哲学思维的核心及精髓,在指导人体生命活动方面具有重要意义。“神不使”理论来源于《素问·汤液醪醴论》,其含义是人身之神无法支撑形体的生命活动。情志失调、营卫不收、余毒未消是肿瘤康复过程中“神不使”的重要病机。精神不进则形体衰敝,神机涣散则痼疾难医,是影响恶性肿瘤转归及预后的重要原因。中医肿瘤康复从整体观念出发,在诊疗过程中注重整体机能的调节及情志的恢复,即“调神”。本文基于“神不使”的核心内涵,探讨中医康复管理新模式,提出调畅情志以安神,调和营卫以养神,清肃余毒以敛神。从不同角度看待、认知造成“神不使”的原因并探讨有效的诊疗方式,探索肿瘤康复学的本质,构建中医“神不使”理论指导下肿瘤康复的认知体系,以期为肿瘤康复提供新视角。

“Spirit”is the core and essence of traditional Chinese medicine(TCM)philosophical thinking,which is of great significance in guiding human life activities.The theory of“spirit’s non-use”comes from Suwen·Tangye Laoli Lun,which means that the spirit of human body cannot support life activities of body.Emotional disorder,non-restoring of nutritive qi and defensive qi,and uncleared residual toxins are important pathogeneses of“spirit’s non-use”in the process of tumor rehabilitation.The scattered spirit leads to the weak body,and the dispersed spirit leads to the difficulty to cure obstinate disease,which are important reasons affecting the prognosis of malignant tumor.TCM tumor rehabilitation starts from the holistic concept,and pays attention to the adjustment of whole function and the recovery of emotions in the process of diagnosis and treatment,that is,“spiritregulating”.Based on the core connotation of“spirit’s non-use”,this paper discussed the new mode of TCM rehabilitation management,and put forward the idea of regulating emotions to calm the spirit,harmonizing the nutritive and defensive levels to nourish the spirit,and purging the residual toxins to astringe the spirit.This paper aimed to recognize the causes of“spirit’s non-use”from different views,discuss effective diagnosis and treatment methods,explore the nature of tumor rehabilitation,and build a cognitive system of tumor rehabilitation under the guidance of“spirit’s non-use”theory of TCM,in order to provide a new perspective for tumor rehabilitation.