气滞血瘀型乳腺癌的病机探析与辨治

Pathogenesis and differential treatment of breast cancer with qi stagnation and blood stasis

关键词:  乳腺癌  气滞血瘀  任脉  冲脉  宗气  天癸

Key words:  breast cancer  qi stagnation and blood stasis  renmai  chongmai  zongqi  tiangui

摘要:

从冲任、天癸、宗气等方面论述气滞血瘀型乳腺癌的病因、病机及辨治。其临床表现为在乳房肿块出现前便长期存在胸闷胸痛、腹部隐痛、不欲饮水，乳房肿块日久不增大也无甚疼痛，却在围绝经期迅速进展，乳腺癌术后表现出患侧上肢肿胀难消、术口渗血渗液难以愈合。认为其发病因素主要与任脉水液停滞水湿、湿阻脉道，冲任胞宫气血盈泄失司兼之宗气不降，产后乳络不通共致血瘀气滞，天癸将竭加剧任脉水湿停滞、血瘀胸乳等因素密切相关。临证以行气利水化瘀为要，用增骨益髓汤加减治疗气滞血瘀型乳腺癌可显著改善临床症状，预防化疗骨髓抑制，疗效显著。

Abstract:

From chongren，tiangui，zongqi and other aspects，this paper discusses the etiology，pathogenesis and differentiation and treatment of breast cancer of qi stagnation and blood stasis. Its clinical manifestations are chest tightness，chest pain，abdominal pain，and no desire to drink water for a long time before the breast mass appears. The breast mass does not grow and does not have much pain for a long time，but it progresses rapidly in the perimenopausal period. After breast cancer surgery，the upper limb of the affected side is swollen and difficult to heal，and the bleeding and oozing fluid at the surgical opening are difficult to heal. The main pathogenic factors are related to the stagnation of water and dampness in the ren meridian，the obstruction of the meridian by dampness，the loss of qi and blood in the chongren uterus，and the inability to lower the zongqi. Postpartum milk meridian obstruction leads to blood stasis and qi stagnation，and the exhaustion of tiangui exacerbates the stagnation of water and dampness in the ren meridian，as well as blood stasis in the chest and breast. The clinical treatment of breast cancer should focus on promoting qi，promoting diuresis and removing blood stasis. Zenggu Yisui Decoction in the treatment of breast cancer of qi stagnation and blood stasis type can significantly improve clinical symptoms，prevent chemotherapy myelosuppression，and the curative effect is significant. A proven case was attached.