首页|门九章教授基于"功能五态"应用四逆汤治疗放化疗后腹泻探析

门九章教授基于"功能五态"应用四逆汤治疗放化疗后腹泻探析

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中国每年恶性肿瘤新增人数不断增长,且病死率较高.尽管中国的恶性肿瘤负担近年来相对稳定,但仍极重,给患者带来很大痛苦的同时也给其家庭带来很大的负担.放化疗作为现代各种恶性肿瘤的主要治疗手段,其不良反应较明显、常见,除恶心、呕吐之外腹泻也较为多见,中医药在恶性肿瘤疾病治疗上显示出更大的临床价值.门九章教授通过在临床实际中对于患者整体状态的认识,提出"功能五态"学说,认为放化疗后腹泻多见脏腑阳气不足或衰微,对应其中的功能不足态与功能衰微态.门教授尤其重视阳气,阳气主动、主化、主生,常占主导地位,阳易生而阴难速长,故较之补阴,兴阳收效更捷,因此门氏流派认为兴阳、护阳是临床诊治之关键.门教授提出《伤寒论》中四逆汤是治疗功能不足态及功能衰微态的代表方剂,主要治疗原则为固护人体正气,振兴人体功能,对于恶性肿瘤放化疗后出现腹泻者可使用四逆汤以振兴功能、回阳止泻.文章选取门九章教授治疗放化疗后腹泻的验案 3 例,试探讨四逆汤治疗此类疾病的辨证方法与用方技巧,发现"怕冷,脉沉细"等阳虚症可作为临证时的脉证参考,癌症患者本身正气亏虚,功能衰弱,故而治疗时门教授着眼于患者整体功能,使用四逆汤以振兴功能,恢复阳气.
Professor MEN Jiuzhang's exploration on treating diarrhea after radiotherapy and chemotherapy with the Sini decoction based on the doctrine of"functional five states"
The number of new cancers in China is increasing every year,and the mortality rate is relatively high.Although the cancer burden in China has been relatively stable in recent years,the cancer burden is extremely heavy yet,causing great pain to patients and a great burden to their families.As the main treatment method for modern cancers,radiotherapy and chemotherapy have obvious and common adverse reactions.In addition to nausea and vomiting,diarrhea is also more common.TCM has shown greater clinical value in the treatment of malignant tumor diseases.Professor MEN Jiuzhang grasped the overall state of patients in clinical practice,put forward the theory of five functional states.It is considered that diarrhea after radiotherapy and chemotherapy is mostly due to deficiency or decline of Yangqi(阳气),corresponding to the functional deficiency state or functional decline state.Professor MEN pays special attention to Yangqi,Yangqi is active,germinal,and dominant.Yang is easy to be born,but Yin is difficult to grow quickly,so promoting Yang is more quickly.Promoting and protecting Yang is the key to clinical diagnosis and treatment.Professor MEN proposed the Sini decoction(四逆汤)as a representative prescription to treat functional insufficiency and functional decline.The main treatment principle is to protect healthy Qi and revitalize human function.People with diarrhea after radiotherapy and chemotherapy of malignant tumor can take the Sini decoction to revitalize their functions,restore Yang and stop diarrhea.The author selected 3 cases of Professor MEN Jiuzhang's treatment of diarrhea after radiotherapy and chemotherapy,tried to explore the syndrome differentiation methods and prescription techniques of the Sini decoction to treat such diseases,and found that Yang deficiency syndrome symptoms such as fear of cold,deep and fine pulse can be used as the reference of pulse syndrome in clinical practice.Cancer patients themselves are deficient in vital Qi and weak in function.Therefore,Professor MEN focuses on the overall function of patients during treatment,and uses the Sini decoction to revitalize functions and restore Yangqi.

The Sini decoctionThe tumor radiation and chemotherapyDiarrheaThe first batch of TCM academic schools

赵水旺、王甜凤、赵鑫、李孝波

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达州中医药职业学院,四川 达州,635000

山西中医药大学,山西 太原,030024

四逆汤 肿瘤放化疗 腹泻 国家首批中医学术流派

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201705D131021

2024

中医临床研究
中华中医药学会

中医临床研究

影响因子:0.839
ISSN:1674-7860
年,卷(期):2024.16(8)
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