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何若苹辨治食管癌经验探析

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[目的]总结何若苹教授临床辨治食管癌的经验.[方法]通过跟诊学习,收集、整理、分析相关医案,从病因病机、治则治法方面阐述何若苹教授治疗食管癌的临床经验,并附医案一则加以佐证.[结果]何若苹教授认为食管癌发病总以脏腑虚弱为本,气滞、痰浊、瘀血、热毒等病理因素为标.治疗时采用"扶正固本,抗癌攻邪,随证遣药"三方面相辅相成的治疗方法,扶正固本尤以脾胃肾为主;抗癌攻邪主要包括行气散结、化痰祛瘀、清热解毒等治法,强调祛邪有度,勿犯"虚虚实实"之戒;随证遣药即对手术、放化疗、局部支架置入后的患者不适症状进行随证处理,提高患者生活质量.所附医案,上述三方面原则贯穿治疗全程,取得良好疗效.[结论]通过阐述"扶正固本,抗癌攻邪,随证遣药"原则在食管癌治疗中的运用,总结何若苹教授的临证用药经验,对食管癌的临床治疗具有一定的借鉴意义.
Clinical Experience of HE Ruoping in Esophageal Cancer
[Objective]To present Professor HE Ruoping's clinical experience in treating esophageal cancer.[Methods]Through the follow-up study,relevant medical cases were collected,organized and analyzed to describe the clinical experience of Professor HE Ruoping in the treatment of esophageal cancer in terms of the etiology and mechanism of the disease,and the rules and methods of treatment.A medical record was attached as evidence.[Results]Professor HE Ruoping believes that the pathogenic characteristic of esophageal cancer is a deficiency in origin and an enrichment in symptom.Deficiency in origin indicates weakness in Zang and Fu,while enrichment in symptom suggests there're Qi stagnation,phlegm,blood stasis and hot toxin."Strengthen healthy Qi,eliminate pathogens,and treat according to the symptoms"is the therapeutic approach used to treat esophageal cancer.The aim is to strengthen Zang and Fu,specifically the spleen,stomach and kidney.Treatments for anti-cancer mainly include moving Qi and dissipating mass,eliminating phlegm and removing blood stasis,clearing heat and toxin,etc.It emphasizes that the elimination of pathogenic factors should be carried out in an appropriate manner and should not hurt the body's positive Qi.Treating according to the symptoms means treating patients with various kinds of uncomfortable symptoms after surgery,radiotherapy and local stent placement to improve their quality of life.In the attached medical case,the above three principles were carried through the whole treatment process,and achieved good therapeutic effect.[Conclusion]By expounding the principle of"strengthen healthy Qi,eliminate pathogens and treat diseases according to the symptoms",it has summarized Professor HE Ruoping's clinical experience in the treatment of esophageal cancer,which is of some significance for the clinical treatment of this disease.

esophageal cancerdysphagiatraditional Chinese medicinetreatment based on syndrome differentiationstrengthening healthy Qi and eliminating pathogensmedical casefamous doctor's experienceHE Ruoping

邓泽欣、俞蒙洁、陈旖雯、赖芊、赵洁、何若苹

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浙江中医药大学第三临床医学院 杭州 310053

浙江中医药大学附属第三医院

食管癌 噎膈 中医药 辨证论治 扶正祛邪 医案 名医经验 何若苹

全国老中医药专家传承工作室建设项目何若苹传承工作室项目浙江省中医药局项目

国中医药人教发[2016]42号2020ZB134

2024

10.16466/j.issn1005-5509.2024.08.008

浙江中医药大学学报
浙江中医药大学

浙江中医药大学学报

CSTPCD
影响因子：1.049
ISSN：1005-5509
年,卷(期)：2024.48(8)