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浅析前列腺癌根治术后尿失禁

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前列腺癌根治术后尿失禁外因为金刃损伤肌肉筋脉,耗伤气血,宗气失于固摄;内因是年老肝肾亏虚,肾气约束乏力.其病位在精室(前列腺)和膀胱,病机为肾气、宗气(脾肺之气)功能失常,治疗应补气、升提宗气、补益肾气,药用黄芪、柴胡、党参、白术、桑寄生、续断、桑螵蛸、金樱子、熟地黄、山茱萸、合欢皮、覆盆子等.临证需注意:(1)以益气升提为要,黄芪可重用至30~60 g,必要时可加升麻6~9g以助升提宗气之力;(2)健脾益气不可少,用党参、白术补益脾肺;(3)心情不畅,或情绪抑郁者,可加制香附9g,佛手9 g;(4)相火亢盛者,加知母、黄柏、龟板以滋阴降肝肾相火;(5)痰浊、瘀血、热毒结聚者,加浙贝母、牡蛎、玄参解郁、软坚、散结.
An Analysis of Urinary Incontinence After Radical Prostatectomy for Prostate Cancer
After radical prostatectomy,urinary incontinence is caused by damage to muscles,tendons,and meridians due to the golden blade,which consumes qi and blood and causes the loss of ancestral qi.The internal cause is the deficiency of liver and kidney in old age,and fatigue because of restraint of kidney qi.The disease is located in the seminal chamber(prostate)and bladder,and the patho-genesis is dysfunction of kidney qi and ancestral qi.(spleen-lung qi).Treatment should supplement qi,elevate ancestral qi,and nourish kidney qi.Huangqi(Radix Scutellariae),Chaihu(Radix Bupleuri),Dangshen(Radix Codonopsis),Baizhu(Rhizoma Atractylodis Mac-rocephalae),Sangjisheng(Herba Taxilli),Xuduan(Radix Dipsaci),Sangpiaoxiao(Oötheca Mantidis),Jinyingzi(Fructus Rosae Laevi-gatae),Shudi(Radix Rehmanniae Praeparata),Shanzhuyu(Fructus Corni),Hehuanpi(Cortex Albiziae),Fupenzi(Fructus Rubi),etc.Attention should be paid in clinical practice:(1)The key is to replenish qi for elevating qi.Huangqi(Radix Scutellariae)can be added up to 30-60 g,and if necessary,6-9 g of Shengma(Rhizoma Cimicifugae)can be added to help elevate and enhance ancestral qi;(2)Invigorating the spleen and replenishing qi are essential,so Dangshen(Radix Codonopsis),and Baizhu(Rhizoma Atractylodis Macrocephalae)can be used to nourish the spleen and lung;(3)For those who are feeling down or depressed,9 g of Xiangfu(Rhizoma Cyperi)and 9 g of Foshou(Fructus Citri Sarcodactylis)can be added;(4)For those with excessive heat,Zhimu(Rhizoma Anemarrhe-nae),Huangbai(Cortex Phellodendri Chinensis)and Guiban(Plastrum Testudinis)can be used to nourish yin and reduce liver-kidney ministerial heat;(5)For those with phlegm turbidity,blood stasis,and accumulation of heat and toxins,Zhebeimu(Bulbus Fritillariae Thunbergii),Muli(Concha Ostreae),and Xuanshen(Radix Scrophulariae)can be added to relieve depression,soften hardness,and disperse nodules.

urinary incontinenceradical prostatectomy for prostate cancerreplenishing qi for elevating qiinvigorating the spleen and replenishing qi

卓鹏伟

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上海市中医文献馆,上海 200020

尿失禁 前列腺癌根治术 益气升提 健脾益气

陈熠上海市名老中医学术经验研究工作室建设项目

SHGZS-202231

2024

河南中医
河南省中医药学会 河南中医学院

河南中医

影响因子:0.968
ISSN:1003-5028
年,卷(期):2024.44(8)
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