摘要
李建生教授认为,正气虚损是肺癌的发病基础,病位在肺、脾、肾三脏,痰瘀癌毒是致病因素,痰浊、血瘀、癌毒为患,脏气受损,痰瘀毒互阻是关键,其总的病机特点为本虚标实而虚实兼见。李教授认为,肺癌常见基础证为肺气虚证、脾气虚证、肾气虚证,以肺为始,渐及脾肾而出现肺脾气虚证、肺肾气虚证,气虚损阴可致肺肾气阴两虚证。故益气固本为根本大法,祛痰化瘀解毒治其标。肺气虚证治宜补益肺气,选用补肺汤加减;肺脾气虚证治宜培土生金,健脾补肺,选用六君子汤加减;肺肾气虚证治宜补肺益肾,选用人参蛤蚧散加减;肺肾气阴两虚证治宜益气养阴,补肺滋肾,选用生脉饮合保元汤加减。李教授运用益气固本法并非单纯运用补益药呆补,而是常用平调和缓之品,酌配理气之药调畅气机,缓缓图之;其用药轻灵,强调药量不宜过大,忌过量使用甘温、滋腻、苦寒、峻猛之品,攻伐太过则正气益虚;慎用辛散、酸敛、重浊之剂,以防肺气不降、邪气恋肺引发其他变证;遇宿疾外感新邪,则及时宣散外邪,不过早应用收敛固涩药物以防闭门留寇,且不单纯扶弱补虚以致外邪留恋,使病情加重。
Professor Li Jian-sheng believes that the pathogenesis of lung cancer is based on the deficiency of healthy qi.The disease is located in the lung,spleen and kidney.Phlegm stasis and cancer toxin are the pathogenic factors.Phlegm turbidity,blood stasis and cancer toxin are the causes.The damage of viscera qi and intermingled of phlegm turbidity,blood stasis and cancer toxin are the key factors.The overall pathogenesis is characterized by deficiency as primary and excess as secondary,intermingled deficiency and excessAccording to Professor Li,the common basic syndromes of lung cancer are lung qi deficiency syndrome,spleen qi deficiency syndrome and kidney qi deficiency syndrome.The pathogens first attack the lung,then gradually affect the spleen and kidney,which can lead to syndrome of lung-spleen qi deficiency,syndrome of lung-kidney qi deficiency,syndrome of lung-kidney qi and yin deficiency.Therefore,supplanting qi and consolidating foundation is the treating principle,while eliminating phlegm,removing blood stasis and detoxification is used to treat secondary symptoms.For syndrome of lung qi deficiency,the treatment should focus on supplementing lung qi,so Modified Lung-Supplementing Decoction can be used.For syndrome of lung-spleen qi deficiency,the treatment should focus on banking up earth to generate metal,so Modified Six Gentlemen Decoction can be used.For syndrome of lung-kidney qi,the treatment should focus on nourishing the lung and kidney,so Modified Ginseng and Gecko Powder can be used.For syndrome of lung-kidney qi and yin deficiency,the treatment should focus on nourishing qi and yin to tonify the lung and kidney,so Pulse-Engendering Decoction combined with Modified Original-Qi-Preserving Decoction can be used.Professor Li′s method of supplementing qi and consolidating foundation is not just to use tonic drugs,but to use mild products combined with qi-regulating ones to adjust qi movement slowly.He uses medicine lightly and tries to avoid large doses,overusing sweet,greasy,bitter and fierce products because attacking too much will lead to insufficient healthy qi.He is cautious when using of pungent,acid astringent and heavy turbid drugs to prevent lung qi from lowering and other deterioratedsyndromes caused by pathogenic qi lingering in the lung.In case of a new external pathogen of a long-standing disease,he thinks that the external pathogen should be released in time.He tries to avoid using astringent drugs early to prevent the risk of bandits to stay behind closed.Moreover,he does not nourish deficiency only in order to prevent external pathogen from lingering and aggravating the disease.
作者
王丁超
周素贞
WANG Ding-chao;ZHOU Su-zhen(Puyang Hospital of TCM,Puyang,Henan,China,457001;The First Affiliated Hospital of Henan University of CM,Zhengzhou,Henan,China,450000)
出处
《河南中医》
2020年第6期855-858,共4页
Henan Traditional Chinese Medicine
基金
国家中医药管理局第六批全国老中医药专家学术经验继承项目{国中医药人教发[2017]29号}。
关键词
肺癌
益气固本法
肺气虚证
肺脾气虚证
肺肾气虚证
肺肾气阴两虚证
李建生
lung cancer
method of supplementing qi and consolidating foundation
syndrome of lung qi deficiency
syndrome of lung-spleen qi deficiency
syndrome of lung-kidney qi deficiency
syndrome of lung-kidney qi and yin deficiency
Li Jian-sheng
