基于“肝为气化之始”探讨恶性肿瘤与情志关系

To Explore Relationship Between Malignant Tumor and Emotion Based on“Liver Initiates Qi Transformation”

张锡纯提出“肝为气化之始”,其理论核心包括3个方面:元气萌芽于肝、肝疏泄气机、他脏以助气化。若情志异常导致郁怒伤肝则元气不足;肝失疏泄则气机失调;肝气横逆则脾衰胃败。中医学认为正气亏虚、气机失调、脾胃衰败的动态演变是恶性肿瘤发生发展的重要病机。正气亏虚则人体抗邪能力下降;气机失调则气血津液输布障碍,痰瘀互结,毒邪停滞;脾胃衰败则一身俱衰。因此对恶性肿瘤治其未发应益气调肝散结,治其已成应疏肝调气解毒,治其传变当敛肝补气固脱,力求为恶性肿瘤的防治提供新视角。

ZHANG Xichun proposed that“liver initiates qi movements”.The core of this theory includes three aspects:original qi sprouts in liver,liver regulates qi movement,and other zang-organs assist qi transformation.Abnormal emotions lead to depression and anger damaging liver which results into insufficient original qi;liver failing to regulate leads to disorder of qi movement;liver qi rebellion leads to weakness of spleen and stomach.Traditional Chinese medicine believes that the dynamic evolution of healthy qi deficiency,disorder of qi movement,and weakness of spleen and stomach is an important disease mechanism for the occurrence and development of malignant tumor.Deficiency of healthy qi leads to decreased ability against pathogenic qi by human body;disorder of qi movement leads to the obstructing distributions of qi,blood and body fluid,the inter-mingled phlegm and blood stasis,and stagnation of toxic pathogen;weakness of spleen and stomach results into weakness of the whole body.Therefore,in the treatment,for the disease before onset,tonifying qi,regulating liver and resolving knot should be applied,for the disease after onset,soothing liver,regulating qi and detoxifying should be applied,for the disease after transmission,astringing liver,tonifying qi and consolidating should be applied,so as to provide a new perspective for the prevention and treatment of malignant tumors.