金军教授运用角药论治岭南大肠癌经验

Professor JIN Jun’s experience in treating colorectal cancer in Lingnan region with tripartite medicines

大肠癌是常见恶性肿瘤,发病率高。中医认为,大肠癌多因机体正气不足,久居湿地,脾胃受损致运化失司,或忧思抑郁致气滞血瘀,或湿热内生致热毒蕴结于脏腑,流泛于大肠所致。岭南气候湿热,历代医家论述人群患病特征均有显著的地域特色。金军是岭南地区名中医,对大肠癌的诊治具有丰富的经验,擅长用角药理论遣方用药。金军教授基于岭南地区气候、人群体质特点,认为患病人群普遍存在脾虚失健、湿邪内蕴的临床特征,并从大肠癌虚、湿、痰、瘀、毒的病机入手,提出将“扶正清毒”法贯穿整个治疗过程,且擅用“南药”,符合地域患病特点。其经验方“扶正抗癌方”以益气健脾、化痰消积、解毒祛瘀为法,运用角药理论配伍使用,药简力专,效验颇佳。文章总结了治疗大肠癌的常用角药5组:五指毛桃-白术-茯苓健脾祛湿,党参-白术-山药甘平补虚扶正,半夏-茯苓-广陈皮燥湿化痰,青皮-鸡内金-牡蛎破气消积,红藤-败酱草-白花蛇舌草解毒散瘀、活血止痛。另附医案一则以佐证,为岭南医家运用角药治疗大肠癌提供有益的借鉴经验。

Colorectal cancer is a common malignant tumour with a high incidence rate.According to traditional Chinese Cmedicine,colorectal cancer is mostly caused by vital Qi(气)deficiency in the body,living in wetland for a long time,and damage to the spleen as well as stomach,resulting in dysfunction of transport and transformation,anxiety and melancholy,leading to Qi stagnation and blood stasis,or endogenous damp heat,causing heat-toxins accumulation in Zang-Fu(脏腑)and the large intestine.Lingnan's climate is hot and humid.The medical doctors of all generations have discussed the characteristics of the population with significant regional characteristics.JIN Jun is a famous traditional Chinese medicine practitioner in the Lingnan region who has rich experience in the diagnosis and treatment of colorectal cancer.Professor JIN Jun is good at using the theory of triangle medicines to dispense prescriptions and medicines.Professor JIN Jun suggests that patients in the Lingnan region display clinical signs of spleen deficiency and dampness accumulation,which can be attributed to the local climate and physical characteristics of the population in the region.Based on the etiology of colorectal cancer,which includes deficiency,dampness,phlegm,blood stasis,and toxicity,Professor JIN Jun proposed a method called“Fuzheng Qingdu”(扶正清毒).This approach covers the entire treatment process,and the professor is highly skilled in using Southern Medicines,which aligns with the regional characteristics of the disease.The Fuzheng Kang’ai prescription(扶正抗癌方)is an empirical prescription that promotes Qi(气),strengthens the spleen,dissolves phlegm,solves indigestion,detoxifies and eliminates blood stasis.It is based on the tripartite medicine theory.That is simple and specialised in medicines,showing effects on numerous cases.This article summarises five categories of tripartite medicines commonly used in treating colorectal cancer.Wuzhi Maotao(Fici Hirtae Radix.),Baizhu(Bighead atractylodes rhizome)and Fuling(Poria)are used to strengthen the spleen and eliminate dampness.Dangshen(Radix Codonopsis),Baizhu and Shanyao(Rhizoma Dioscoreae),sweet and neutral in nature,are employed to strengthen health and tonify deficiency.Banxia(Rhizoma Pinelliae),Fuling and Guangchenpi(Citri Reticulatae Pericarpium)are used to dry dampness and dissolve phlegm.Qingpi(Citri Reticulatae Pericarpium Viride),Ji’neijin(Galli Gigerii Endothelium Corneum)and Muli(Ostreae Concha)are used to release Qi stagnation and solve indigestion.Hongteng(Sargentodoxa Cuneata),Baijiangcao(Patriniae Herba)and Baihuasheshecao(Herba Hedyoti Diffusae)are used to remove toxicity,solve indigestion,promote blood circulation,and relieve pain.One medical case is attached as evidence,providing a useful reference experience for Lingnan doctors to use tripartite medicines in the treatment of colorectal cancer.