防治恶性肿瘤转移理论探讨.docVIP

防治恶性肿瘤转移的理论探讨 辛海 马琴 （北京中医医院肿瘤科，北京，100010） 摘要：防治恶性肿瘤转移在肿瘤治疗中占有重要地位，运用五脏五行生克理论，经络气血走向以及气的固摄理论，对恶性肿瘤转移进行中医理论分析，提出五脏生克决定转移脏腑，转移部位与经络气血走向有关，转移是气失固摄的结果。恶性肿瘤转移的防治以辨证论治为核心，以截断扭转为指导思想。 关键词：恶性肿瘤 转移 五脏生克 经络气血走向 气失固摄 中图分类号：R273 文献标识号：A 文章编号： Theory Discussion on the Prevention and Treatment of Metastasis of Malignant Tumor XINHAI MAQIN (Beijing Hospital of TCM, ,Beijing,100010,China) Abstract: It is important to prevent and treat metastasis of malignant tumor in the treatment of tumor. The cause of metastasis of malignant tumor is analysed by using Traditional Chinese Medicine theories such as generation and restriction of five viscera (five elements), moving direction of channels, qi, and blood, and consolidating and governing action of qi. Metastatic visceral and bowels are thought to be determined by generation and restriction of　five visceral. Metastatic regions are thought to be related to the direction of channels, qi,and blood. Metastasis is thought to be the result of lackness of consolidating and governing action of qi. Treatment by syndrome differentiation should be mainly used in preventing and treating of metastasis of malignant tumor, and “cut off and diversion” should be adopted as the instructive thought. Key words: malignant tumor; metastasis; moving direction of channels, qi, and blood; lackness of consolidating and governing action of qi. 恶性肿瘤的转移一直是医学界的难题，更是影响肿瘤患者预后的关键因素，如何控制转移是医学界研究的热点,针对即将转移或为防止进一步转移的脏腑进行调护是中医治疗肿瘤的一个特点。张仲景在《金匮要略》中云：“见肝之病，知肝传脾，当先实脾…”，笔者认为未病先防，已病防变的思想在肿瘤转移的预防控制中尤为重要。经过对肿瘤转移患者的临证观察，以中医五脏五行生克理论，经络气血走向以及气的固摄理论对恶性肿瘤转移进行分析如下。 转移脏腑与五脏（五行）生克有关 中医对于疾病传变一直以相生相克的善恶规律来解释，相生为顺，相克为逆。五版《中医诊断学》对病色生克有详细的论述，生我者为吉中之顺，我生者为吉中小逆，我克者为凶中之顺，克我者为凶中之逆。举例说明如肺（金）病见脾（土）病为吉中之顺（土生金），肺（金）病见肾（水）病为吉中小逆（金生水），肺（金）病见肝（木）病为凶中之顺（金克木），肺（金）病见心（火）病为凶中之逆（火克金）。恶性肿瘤始发必居于五脏某一脏系统中，其传变必遵循五脏（五行）生克善恶规律，从传变的难易程度来考察，相生为易，相克为难，故传变先从相生脏来传，再从相恶脏来传。虽然转移前的肿瘤所在病位与中医脏腑并不完全相同，但从转移前的临床症状表现来分析病位，可以认为以下肿瘤所在病位如肺癌属肺金受病，肝癌以肝胆症状表现为主，病位在肝，属肝木受病。胃癌肠癌及食管癌以受纳传化功能失调为主，病位属脾（土），为脾土受病。乳腺癌未转移前以情绪