舒琦瑾教授“澄源固本”法辨治原发性肝癌的用药特色

Medication Characteristics of Professor SHU Qijin Using“Clarifying the Source and Strengthening the Foundation”Method in Differentiation and Treatment of Primary Liver Carcinoma

[目的]探讨浙江省名中医舒琦瑾教授治疗原发性肝癌的用药特色。[方法]从肝癌病机出发探析舒师辨治肝癌的特色,综合分析舒师对肝癌患者的处方用药情况。[结果]肝癌病机复杂,多以肝郁脾虚、脏腑气血亏虚为基础,又有久病、刀圭、放化疗致耗气伤阴,气血运行不畅,水液代谢受阻,继而产生气郁、血瘀、水饮痰湿、热毒等内生之邪。舒师临证多用疏肝健脾之法,针对“气血水”相关的内生之邪强化用药,缓消内邪;重视热毒,多用清热解毒利湿药物,减少肿瘤转移复发;始终坚守辨证论治、扶正固本的治法,强调健脾益气养阴;结合中医药的现代药理学研究及药物归经学说,精准抗癌。[结论]舒师辨治肝癌时遵循澄源固本之法,谨守病机,紧抓证型,调节机体气血水之运行,祛邪澄源,扶正固本,精确用药,全面处方,减少肝癌恶化、转移、复发。

[Objective]To explore the medication characteristics of Professor SHU Qijin,a renowned traditional Chinese medicine(TCM)practitioner in Zhejiang Province,in the treatment of primary liver carcinoma(PLC).[Methods]A comprehensive analysis was conducted on the characteristics of Professor SHU’s differentiation and treatment of PLC,and Professor SHU’s prescription medication for PLC patients were explored from the perspective of pathogenesis.[Results]The pathogenesis of PLC is complex,often based on liver depression and spleen deficiency,as well as organ Qi and blood deficiency.Prolonged illness,surgical operation,radiotherapy and chemotherapy can lead to Qi depletion and Yin damage,poor circulation of Qi and blood,obstruction of water and fluid metabolism,and subsequent endogenous evils such as Qi stagnation,blood stasis,water consumption,phlegm dampness and heat toxicity.Professor SHU often uses the method of soothing the liver and strengthening the spleen in clinical practice;strengthens medication for the related endogenous evil of“Qi,blood,and water”to slow down and eliminate the internal evil;pays attention to heat toxicity and use more heat clearing,detoxifying,and uses diuretic drugs to reduce tumor metastasis and recurrence;remembers to treat according to syndrome differentiation,strengthen the body resistance,strengthen the spleen,replenish Qi,and nourish Yin;combines modern pharmacology research of TCM and the theory of drug meridians,implements precise anti-cancer measures.[Conclusion]Professor SHU follows the method of clarifying the source and consolidating the root when diagnosing and treating PLC,adheres to the pathogenesis,focuses on syndrome types,regulates the circulation of Qi,blood,and water in the body,dispels pathogenic factors,clarifies the source,strengthens the body,uses precise medication,and provides comprehensive prescriptions to reduce the deterioration,metastasis,and recurrence of PLC.