首页|林胜友基于通降理论从肝脾分层辨治胰腺癌经验

林胜友基于通降理论从肝脾分层辨治胰腺癌经验

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胰腺癌作为消化系统常见恶性肿瘤,具有高恶性和低早期诊断率的特点,且发病率和病死率高,生存率低,治疗选择有限,患者的生活质量堪忧.虽然现代医学治疗手段多种多样,但在实际临床诊治中仍面临疾病复发率高、耐药性强、药物不良反应多等挑战.林胜友教授在恶性肿瘤防治领域经验丰富,对中医药治胰腺癌有独特见解,临证时多基于通降理论,从肝脾分层辨治.林教授认为胰腺癌的诊治需综合现代多学科治疗前后的证候变化,其核心病机以脏腑气机通降失司为本,以肝郁脾虚为因,以痰凝、瘀血、湿热等为标,提出基于"以通为用,以降为顺"的六腑生理特点,根据肝郁与脾虚的差异精准分层辨证,重视标本兼治,提出以"疏肝三法、健脾三法、肝脾同调"为主要治则,施以疏肝健脾为核心的差异性治法,以通降和中为根本目的,辅以化痰祛湿、活血通络、清利湿热等诸多治标之法,强调以虚实共参、攻补兼施、标本并重为指导,发挥中医药增效减毒之优势,并通过验案进一步阐述基于通降理论从肝脾分层精准辨治胰腺癌的经验,为缓解胰腺癌患者临床症状、延缓胰腺癌进展、提高生活质量提供临床思路.
Professor LIN Shengyou's experience in differentiating and treating pancreatic cancer from liver and spleen based on the theory of Tongjiang
Pancreatic cancer,as a prevalent malignant tumor of digestive system,is characterized by high malignancy and low early diagnosis rate,with high incidence and mortality rates,resulting in poor survival and limited therapeutic options,which raises concerns about the quality of life of patients.Although modern medical treatments are available,clinical management is still confronted with challenges such as high rate of disease recurrence,high level of drug resistance,and numerous medication adverse reactions.Professor LIN Shengyou,with extensive experience in the prevention and treatment of malignant tumors,offers unique insights into the application of traditional Chinese medicine in treating pancreatic cancer.In clinical experience,Professor LIN often treats pancreatic cancer through stratifying differentiation of liver and spleen,utilizing the Tongjiang(通降)theory.The professor emphasizes the importance of changes in symptoms before and after modem multidisciplinary treatments in the diagnosis and treatment of pancreatic cancer.The main pathogenesis involves Qi(气)disorder in the viscera,characterized by liver Qi stagnation and spleen Qi deficiency,along with phlegm stagnation,blood stasis,and dampness-heat.Professor LIN suggests distinguishing the extent of liver stagnation and spleen deficiency accurately based on the Tongjiang theory,which is the physiological characteristics of the six Fu(腑)organs.The professor prioritizes the integrated treatment of addressing both the symptoms and the root cause,proposing the use of the three methods of soothing the liver,three methods of strengthening the spleen,and liver-spleen co-regulation as principal therapeutic guidelines,implementing a personalized treatment protocol with a core focus on liver-soothing and spleen-strengthening.The primary goal is to maintain unblocked,purged,and balance viscera,accompanied by symptomatic treatment such as addressing phlegm,dampness,blood circulation,collaterals,and dampness-heat.The professor also highlights the significance of recognizing excess and deficiency in disease status,combining disease treatment with reinforcement and elimination,and addressing both symptoms and root causes,which can be used to leverage the therapeutic and detoxifying effects of traditional Chinese medicine.We further illustrate the experience of precisely stratifying and treating pancreatic cancer from the perspectives of the liver and spleen based on the Tongjiang theory through clinical cases.This approach aims to provide clinical insights for alleviating clinical symptoms,slowing the progression,and enhancing patients'quality of life.

Pancreatic cancerThe theory of TongjiangSoothing the liver and fortifying the spleenClinical experience

沈科展、姜静、王梦蕾、于哲轩、徐天翔、王曾、董立彬、林胜友

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浙江中医药大学附属杭州市中医院,浙江 杭州,310007

浙江中医药大学附属第一医院(浙江省中医院),浙江 杭州,310003

浙江中医药大学基础医学院,浙江 杭州,310053

浙江中医药大学附属宁波市中医院,浙江 宁波,315016

浙江大学医学院,浙江 杭州,310058

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胰腺癌 通降理论 疏肝健脾 临床经验

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(32)