葛来安教授从痰瘀论治胆囊息肉临床经验总结

Professor GE Laian’s clinical experience in treating gallbladder polyps from the perspective of phlegm and blood stasis

胆囊息肉为一种常见的消化系统疾病,临床上多无明显症状,发病率却逐年增高。此病发病机制尚未明确,西医治疗方案单一。中医通过辨证论治,运用中药治疗胆囊息肉具有良好疗效。葛来安教授通过多年对肝胆脾胃系统疾病的诊治,提出“肝胆是一家,肝脾不分家”的理论,认为胆囊息肉既属于生活方式病,与代谢密切相关;也属于情志致病,与情绪失调密切相关。总结出脾虚肝郁、痰瘀内阻是胆囊息肉发病的主要病机;饮食失节、情志失调是其主要病因;瘀结成块是其关键环节。在治疗上,葛教授博采众方,以五金汤、四逆散、二陈汤为基础,加入疏肝第一药之薄荷、散结消块之莪术、王不留行等,形成自拟方——五金化石排石汤。此方健脾疏肝、化痰祛瘀。葛教授的遣方用药体现了胆病从肝治,肝病从脾看;探因断病,重于清化痰瘀;气血并治,善用散结消肿的治疗特色。本研究介绍葛来安教授从痰瘀治疗胆囊息肉的经验,以期为临床提供参考。

As a common digestive system disease,gallbladder polyps often have no obvious clinical symptoms,but their incidence has been increasing year by year.Many clinical experiences have shown that traditional Chinese medicine(TCM)has a good therapeutic effect on gallbladder polyps through syndrome differentiation and treatment with TCM medicines.The pathogenesis of this disease is not yet clear,and Western medicine treatment plans are single,so more and more patients are choosing TCM.Professor GE Laian,through years of diagnosis and treatment of hepatobiliary and spleen-stomach system diseases,has proposed the treatment characteristics of“The liver and gallbladder are closely related,and the liver and spleen are inseparable”.Combining this with years of clinical practice observations,he believes that gallbladder polyps belong to both a lifestyle disease closely related to metabolism and an emotional disease closely related to emotional disorders.He summarized that the main pathogenesis of gallbladder polyps is spleen deficiency and liver stagnation,with internal phlegm and blood stasis as obstructions.The main causes are improper diet and emotional disorders,and the key link is the formation of stagnant blood and phlegm.In treatment,he adopts various prescriptions,based on modifications of the Wujin decoction(五金汤),Sini San(四逆散),and the Erchen decoction(二陈汤),adding Bohe(Herba Menthae),Ezhu(Rhizoma Curcumae),Wangbuliuxing(Semen Vaccariae),forming the Wujin Huashi Paishi decoction(五金化石排石汤)to invigorate the spleen,soothe the liver,resolve phlegm,and eliminate blood stasis.This reflects the treatment characteristics of treating gallbladder diseases from the liver,treating liver diseases from the spleen,exploring the causes and diagnosing the disease,emphasizing the clearance of phlegm and blood stasis,treating Qi(气)and blood together,and skillfully using the method of resolving stagnation and reducing swelling.This article introduces Professor GE Laian’s experience in treating gallbladder polyps from phlegm and blood stasis,in order to provide reference for clinical practice.