摘要
总结对消化道早癌的中医认识,治疗方法及用药思路;认为消化道早癌病位在脾胃,与肝肾密切相关,中医考虑多与脾胃虚弱,升降失常,肝失疏泄,肾气化失司,水湿代谢输布失常,气机阻滞,络脉瘀滞,邪有所留;或湿阻郁热;或阳气生化不足,阴气凝聚,痰湿、瘀、寒热、毒邪互结而成,辨证时需辨别寒热虚实,治疗上以调脾胃,复升降为先,清热为标,温阳为本,疏肝畅机、祛湿化痰、化瘀散结为辅,酌加解毒药,同时强调分阶段治疗.有症状时辨病论治以治标,症状缓解后三因治宜以治本,同时强调及时筛查,注重饮食生活调养,定期复查.
Abstract
This paper summarized the traditional Chinese medicine understanding,treatment methods and medication strate-gies for early gastrointestinal cancer.It believes that the early digestive tract cancer is located in spleen and stomach,closely re-lated to liver and kidney.Traditional Chinese medicine considers it mainly as spleen and stomach weakness,ascension and de-scent disorder,liver failure,kidney Qi transformation failure,water and dampness metabolism transportation disorder,Qi obstruc-tion,blood stasis in meridians,evil retention;or heat depression due to dampness obstruction,or insufficient Yang Qi causing Yin Qi coagulation,phlegm,blood stasis,cold and heat and toxic evil accumulation.When diagnosing,it is necessary to distinguish cold and heat as well as deficiency and excess,and the treatment should be based on regulating spleen and stomach,restoring as-cending and descending,clearing heat as the standard,and warming Yang as the basis,with the auxiliary of dispelling liver and regulating Qi movement,eliminating dampness,resolving phlegm,dispelling blood stasis and dissipating mass,and adding detoxifi-cation drugs.At the same time,it emphasizes stage-by-stage treatment.When there are symptoms,the diagnosis and treatment should be focused on the symptoms,and when the symptoms are relieved,the three-cause treatment should be based on the root cause.At the same time,it emphasizes timely screening,paying attention to diet and life conditioning,and has regular follow-up.
基金项目
全国中医临床特色技术传承骨干人才培训项目(国中医药[2019]36号)
重庆市科卫联合项目(2021ZY023589)
重庆市中医药重点学科建设项目(十三五)(渝中医2019)
李延萍重庆市级名中医传承工作室项目(渝中医[2020]20号)