1.南京中医药大学附属医院/江苏省中医院,江苏省南京市秦淮区汉中路155号,210029
2.南京中医药大学第一临床医学院
jianwu@njucm.edu.cn
收稿:2024-05-25,
修回:2024-07-01,
纸质出版:2024-10-17
移动端阅览
孙庆敏,张粲粲,郑晓霞等.刘沈林运用“择药任势”思维辨治胃癌经验[J].中医杂志,2024,65(20):2075-2080.
SUN Qingmin,ZHANG Cancan,ZHENG Xiaoxia,et al.LIU Shenlin's Experience in Treating Gastric Cancer with the Thinking of "Prescription According to Tendency"[J].Journal of Traditional Chinese Medicine,2024,65(20):2075-2080.
孙庆敏,张粲粲,郑晓霞等.刘沈林运用“择药任势”思维辨治胃癌经验[J].中医杂志,2024,65(20):2075-2080. DOI: 10.13288/j.11-2166/r.2024.20.003.
SUN Qingmin,ZHANG Cancan,ZHENG Xiaoxia,et al.LIU Shenlin's Experience in Treating Gastric Cancer with the Thinking of "Prescription According to Tendency"[J].Journal of Traditional Chinese Medicine,2024,65(20):2075-2080. DOI: 10.13288/j.11-2166/r.2024.20.003.
总结刘沈林教授运用“择药任势”思维辨证施治胃癌的临床经验。将胃癌诊治思维方法、用药技巧凝练总结为权势、能势、时势、形势4个维度,即辨证强调气的“权势”地位,认为胃癌的发生主要始于脏腑气机失调,强调疏调肝脾之气截断病势;指出湿痰瘀毒是导致“能势”代谢失衡的重要环节,擅长运用破血逐瘀和清热解毒之法阻断能量失衡所致的病理连锁反应,恢复机体稳态;在治疗过程中,根据胃癌分期、时序演化的特点,探讨“时势”背景下正邪交争的盛衰变化,根据不同病程调整攻补药物的剂量以求衡复中;将“形势”与胃癌晚期虚劳状态相接轨,善用大剂量黄芪,配伍灵活,补诸虚不足,旺气生血,通调血脉。
This paper summarized the clinical experience of Professor LIU Shenlin in diagnosing an
d treating gastric cancer with the thinking of "prescription according to tendency". In this paper, the thinking of diagnosis and treatment for gastric cancer and medication skills were summarized into four dimensions: power, energy, chronology and situation. The diagnosis emphasizes the tendency of
qi
power, considering that the onset of gastric cancer primarily stems from the disorder of
qi
movement in
zang
-
fu
organs, and emphasizing the importance of regulating the liver and spleen
qi
to intercept the tendency of disease. It points out that dampness-phlegm-stasis-toxin is a crucial link leading to the metabolic imbalance of body energy, and Professor LIU adepts at using methods such as breaking up blood and expelling stasis, and clearing heat and resolving toxins to block the pathological chain reaction caused by energy imbalance and to restore the homeostasis of the organism. In the treatment process, according to the characteristics of gastric cancer staging and chronological evolution, we will explore the changes of the exuberance and weakness of healthy
qi
and pathogenic
qi
in the context of the chronologic tendency, and adjust the dosage of attacking and tonic medicines in different stages of the disease in order to balance and restore the body. The "situation" is in line with the state of consumptive disease in advanced gastric cancer, Professor LIU skillfully uses large doses of Huangqi (
Astragalus mongholicus
) with flexible combination of medicinals to replenish deficiencies, invigorate
qi
, and regulate blood vessels.
蒋金玲 , 周尘飞 , 王超 , 等 . 2022年度胃癌研究和诊疗新进展 [J]. 中国癌症杂志 , 2023 , 33 ( 4 ): 303 - 314 .
JOSHI SS , BADGWELL BD . Current treatment and recent progress in gastric cancer [J]. CA Cancer J Clin , 2021 , 71 ( 3 ): 264 - 279 .
刘霞 , 李媛媛 , 张乐其 , 等 . 吴门医派及孟河医派学术思想对中医皮肤科发展的影响 [J]. 中医杂志 , 2017 , 58 ( 13 ): 1089 - 1092 .
吴亚东 . “势治”是韩非政治思想的发端和归旨 [J]. 华南师范大学学报(社会科学版) , 1984 ( 1 ): 65 - 70 .
王宏强 . 论韩非子“势”论的内在逻辑 [J]. 兰州大学学报(社会科学版) , 2021 , 49 ( 6 ): 142 - 151 .
曹康迪 , 胡帅航 , 王瑾琨 , 等 . 运用“形气神”思想治疗恶性肿瘤 [J]. 北京中医药大学学报 , 2021 , 44 ( 12 ): 1126 - 1132 .
苗琳琳 , 万生芳 , 张磊 , 等 . 基于黄元御“一气周流、土枢四象”理论探析糖尿病胃轻瘫六期病机与辨治 [J]. 上海中医药杂志 , 2024 , 58 ( 4 ): 67 - 71 .
彭海燕 , 刘沈林 . 刘沈林教授七法辨治胃癌的经验 [J]. 中华中医药杂志 , 2013 , 28 ( 11 ): 3269 - 3271 .
李娟 , 石伯伦 , 李玥 , 等 . 调气解毒法调控恶性肿瘤转移前生态位的思路与探析 [J]. 中医杂志 , 2023 , 64 ( 20 ): 2077 - 2081 .
张再林 . 中国古代“势”的形上学的理论建构及解构 [J]. 学海 , 2014 ( 1 ): 140 - 149 .
齐元玲 , 张庆祥 . 圜道观思维下中医扶正与祛邪治则解读及其意义 [J]. 时珍国医国药 , 2020 , 31 ( 8 ): 1953 - 1955 .
孟祥丽 , 张庆祥 . 圜道观视域下的“肺主治节”探析 [J]. 中华中医药杂志 , 2022 , 37 ( 5 ): 2651 - 2653 .
黄文博 , 潘丽 , 黄娅 , 等 . 基于能量代谢重编程论“阴火”与中医肿瘤发生学 [J]. 中医杂志 , 2022 , 63 ( 10 ): 905 - 909 .
李奕 , 刘福栋 , 庞博 , 等 . 基于肿瘤能量代谢失衡探讨扶正解毒法在慢性结肠炎“炎癌转化”分期干预中的应用 [J]. 中医杂志 , 2022 , 63 ( 3 ): 234 - 239 .
王新苗 , 曹璐畅 , 李杰 . 基于“随变而调气”探讨恶性肿瘤的中医辨治 [J]. 中医杂志 , 2024 , 65 ( 8 ): 796 - 800, 820 .
刘沈林 . 脾胃病临证用药二十七法 [J]. 江苏中医药 , 2019 , 51 ( 12 ): 1 - 5 .
徐克谦 . 中国哲学之“是”与“实、事、史、时、势 ”[J]. 南京师大学报(社会科学版) , 2007 ( 5 ): 29 - 33 .
刘燕 , 吴耀松 , 刘俊 , 等 . 从正邪转化探讨肿瘤病机与治疗 [J]. 北京中医药大学学报 , 2021 , 44 ( 2 ): 183 - 187 .
王琦 . 形神一体的形神观 [J]. 中华中医药杂志 , 2012 , 27 ( 3 ): 652 - 654 .
刘沈林 . 再谈中医治疗肿瘤的特点和时机 [J]. 江苏中医药 , 2020 , 52 ( 9 ): 1 - 3 .
SANO T , COIT DG , KIM HH , et al . Proposal of a new stage grouping of gastric cancer for TNM classification: International Gastric Cancer Association staging project [J]. Gastric Cancer , 2017 , 20 ( 2 ): 217 - 225 .
0
浏览量
0
下载量
1
CSCD
关联资源
相关文章
相关作者
相关机构
京公网安备11010102007558号