摘要
总结李曰庆教授从虚、瘀论治前列腺癌的临床经验.认为前列腺癌发病以肾虚为基础,血瘀为核心病机,湿热、痰浊、癌毒为疾病进展中的关键病理因素.前期病机为肾气亏虚、湿热痰凝;中期为脾肾亏虚、痰凝血瘀;后期为阴虚精亏、瘀浊毒阻.治疗上以补益肾气、滋养肾阴为基本原则,利湿、化痰、祛瘀、清热解毒为主要治法,活血化瘀贯穿疾病治疗始终.早期以根治性治疗为主,辅用龙蛇羊泉汤加减以清利湿热;中期以雄激素剥夺治疗为基础,合用补肾通窍汤加减以脾肾双补,化痰祛瘀;后期主以大补阴丸合六味地黄丸加减,滋阴填精,解毒化瘀,谨防癌毒复发.
Abstract
This paper summarized Professor LI Yueqing's clinical experience in treating prostate cancer by stages from the perspective of deficiency and stasis.It is believed that the onset of prostate cancer is due to kidney deficiency,while blood stasis is the core pathogenesis,and dampness-heat,phlegm-turbid,and cancer toxins are the key patho-logical factors in the progression of the disease.The pathogenesis in the early stage of the disease is kidney qi deple-tion and dampness,heat and phlegm coagulation;in the middle stage,it is spleen and kidney depletion,phlegm coagulation and blood stasis;and in the late stage,the pathogenesis changes into yin deficiency and essence deple-tion,and stasis-turbid toxin obstruction.For treatment,the basic principle is to supplement and boost kidney qi,enrich and nourish the kidney yin.The main treatment methods are draining dampness,dissolving phlegm,dispelling stasis,clearing heat and resolving toxins,and the method of invigorating blood and dispelling stasis runs through the whole course of treatment.In the early stage,radical treatment is mainly used,and Longshe Yangquan Decoction(龙蛇羊泉汤)with modifications is supplemented to clear and drain dampness and heat.In the middle stage,androgen depriva-tion therapy is the basic treatment,and Bushen Tongqiao Decoction(补肾通窍汤)with modifications is used in combi-nation to nourish the spleen and kidney,dissolve phlegm and dispel stasis.In the late stage,Dabuyin Pills and Liuwei Dihuang Pills(大补阴丸合六味地黄丸)with modifications is mainly used to enrich yin and supplement essence,resolve toxins and dissolve stasis,and prevent cancer recurrence.
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