文章摘要
徐新宇,管鹏飞,应志康,等.崔云教授扶正清毒治疗前列腺癌经验[J].浙江中医药大学学报,2022,46(1):6-11.
崔云教授扶正清毒治疗前列腺癌经验
Professor CUI Yun‘s Experience of Strengthening the Body Resistance and Eliminating Toxins on the Treatment of Prostate Cancer
DOI:10.16466/j.issn1005-5509.2022.01.002
中文关键词: 前列腺癌  持续扶正  适时清毒  随证治之  带瘤生存  名医经验  崔云
英文关键词: prostate cancer  continuously strengthening the body resistance  timely eliminating toxins  treating according to the symptoms  survival with tumor  experience of famous doctor  CUI Yun
基金项目: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工作项目(国中医药人教发[2017]29号);浙江省名老中医专家传承工作室建设计划项目(GZS20120030);宁波市医疗卫生品牌学科资助(PPXK2018-07)
作者单位
徐新宇 浙江中医药大学第三临床医学院 杭州 310053 
管鹏飞 浙江中医药大学第三临床医学院 杭州 310053 
应志康 浙江中医药大学第三临床医学院 杭州 310053 
崔云 浙江中医药大学附属宁波中医院 
蒋富贵 浙江中医药大学第三临床医学院 杭州 310053 
沈泽铖 浙江中医药大学第三临床医学院 杭州 310053 
刘嘉豪 浙江中医药大学第三临床医学院 杭州 310053 
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中文摘要:
      [目的] 介绍崔云教授以扶正清毒法治疗前列腺癌的经验。[方法] 通过采集和分析崔师治疗前列腺癌的临床病例,结合其临证治疗前列腺癌的所谈所述,在充分认识病因病机的基础上,全面总结崔师辨治前列腺癌的经验,并举典型医案加以论证。[结果] 崔师认为,前列腺癌好发于55~80岁的中老年人,天癸衰竭、正气亏虚为发病的内在基础,正虚影响代谢,形成水湿、瘀血等病理实邪,留滞前列腺,蕴结腺体,导致前列腺阴阳失衡是产生癌邪、形成前列腺癌的关键。治疗上秉持“持续扶正,适时清毒,随证治之”的原则,“持续扶正”,原因在于患者年老虚损,更经癌邪、手术或放化疗损伤,正虚更甚,故当扶助先后天之本,重视补脾、以善其肾,肝肾同求、益精壮骨;“适时清毒”,原因在于患者接受放化疗即为清除癌毒的过程,且久用清除湿热痰瘀之毒的药物,有碍正气恢复,因此要根据舌苔、脉象及证候改变,阶段性清除;“随证治之”,即根据前列腺癌合并的尿路及其它进展期症状、放化疗及手术后遗症的不同,识别病机,灵活用药。所举医案中,患者已行前列腺根治术,元气受损,脾肾亏虚症状明显,辨为脾肾两虚、气血不足证,治以温肾益脾、补气养血,以圣愈散化裁持续扶助正气,依据舌脉及证候表现等适时清除毒邪,并顾及兼证,综合治疗中使患者病情得到平稳控制,是理法有效之体现。[结论] 崔师辨治前列腺癌秉持扶正清毒的理念,重视固护正气,少用峻猛之品,方药精简,配伍得当,效果显著,为本病的临床辨治提供了新思路。
英文摘要:
      [Objective] To introduce Professor CUI Yun‘s experience of using the method of strengthening the body resistance and eliminating toxins in the treatment of prostate cancer. [Methods] Based on the collection and analysis of Professor CUI Yun‘s clinical cases of prostate cancer, combined with his talks and narration in clinical treatment of prostate cancer, on the basis of full understanding of the etiology and pathogenesis, the experience of Professor CUI Yun in differentiation and treatment of prostate cancer was comprehensively summarized, and a typical medical case was cited to demonstrate. [Results] Professor CUI Yun believes that prostate cancer likes to occur in old middle-aged and old people, such as 55~80 years old. Gradual exhaustion of Tiangui and deficiency of healthy Qi is the intrinsic basis of the disease. Deficiency of healthy Qi affects metabolism, forms pathological excess evils such as dampness and blood stasis, stagnates in prostate, accumulates glands, and leads to the imbalance of Yin and Yang in the prostate, which is the key to produce cancer evil and form prostate cancer. In treatment, the principle of “continuously strengthening the body resistance, timely eliminating toxins, and treating according to the symptoms” should be upheld. “Continuously strengthening the body resistance”, the reason is that the patient is old and weak, more survives from cancer, surgery or radiotherapy and chemotherapy damage, the deficiency is more serious, so it is necessary to support the congenital and postnatal foundation, pay attention to tonifying the spleen to support the kidney, treating the liver and kidney at the same time, tonifying essence and strengthening bone; “timely eliminating toxins”, the reason is that patients receive radiotherapy and chemotherapy which is the process of removing cancer toxins, and the long use of drugs is to remove the poison of damp heat, phlegm and blood stasis, hindering the recovery of healthy Qi, so the toxins should be removed in stages according to the change of tongue coating, pulse and syndrome; “treating according to the symptoms”, that is to identify the pathogenesis and use drugs flexibly according to the different urinary tracts and other advanced symptoms, radiotherapy, chemotherapy and surgical sequelae of prostate cancer. In the medical case, the patient had undergone radical prostatectomy, which led to the vitality damaged and apparent symptoms of spleen and kidney deficiency, and was differentiated as the syndrome of deficiency of the spleen and kidney, Qi and blood, treatment of warming the kidney and nourishing the spleen, tonifying Qi and blood was adopted, and Shengyu Powder was used to strengthen the body resistance continuously, timely eliminating toxins according to the change of tongue coating, pulse and syndrome, at the same time, caring accompanied symptoms. The patient‘s state of disease was controlled smoothly with comprehensive treatment, which reflected the validity of the theories and methods. [Conclusion] Professor CUI Yun‘s differentiation and treatment of prostate cancer adhere to the concept of strengthening the body resistance and eliminating toxins, pay attention to strengthening and protecting healthy Qi, use less harsh and fierce products. He has simplified formulas, appropriate compatibility, and remarkable effect, which provides a new idea for the clinical differentiation and treatment of this disease.
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