“黜浊培本”辨治胃癌思路探讨

Exploring the treatment approach for gastric cancer based on the theory of “Chuzhuo Peiben”

关键词:  黜浊培本  胃癌  癌浊  疏利三焦  治取中州

Key words:  Chuzhuo Peiben  gastric malignancy  Aizhuo  dredging and regulating the San jiao  treating the middle energizer

摘要:

文章探讨基于“黜浊培本”理论辨治胃癌思路。根据脾胃升降相因特点及“癌浊”病机特性，临证动态权衡正邪强弱，揆度“黜浊”与“培本”力度而遣方施药，可归纳为补护并举以助戊土之阳气，调燮升降以健脾胃之运化，扶火抑木以复其生克平衡，急下缓滋以存阳明之津液。疏利三焦为纵，治取中州为横，以期中气之轴、四维之轮“周流”转枢如常，五脏六腑气血调和。附典型病案1则，以资佐证。

Abstract:

This article discusses the strategy for the treatment of gastric cancer based on the theory of “Chuzhuo Peiben”. According to the characteristics of the ascending and descending natures of the spleen and stomach，as well as the pathogenetic feature of “Aizhuo”，clinical practice involves the comparison between the relative strength of healthy qi and pathogenic factors. Furthermore，we carefully determine the appropriate emphasis on either “Chuzhuo”（eliminating pathogens） or “Peiben”（reinforcing healthy qi） when formulating prescriptions. This approach can be summarized as follows：reinforcing and supporting the stomach’s yangqi；regulating and harmonizing the ascending and descending functions of the spleen and stomach to restore their transportation and transformation；regulating the heart（fire） and liver（wood） to re-establish the balance of generation and restriction；employing urgent purgation for excess patterns and gentle nourishing for deficiency patterns to preserve the fluids of the Yangming. The longitudinal approach involves dredging and regulating the Sanjiao，while the horizontal strategy focuses on treating the middle energizer. The goal is to restore the normal state，characterized by a freely moving pivotal Qi axis and smoothly rotating “wheels”in the four dimensions. Thereby，harmony of qi and blood in the five zang-organs and six fu-organs can be achieved. A typical case study is included for illustration.