| 张依婷,沈敏鹤,阮善明.沈敏鹤治疗胰腺癌经验浅析[J].浙江中医药大学学报,2022,46(1):82-85. |
| 沈敏鹤治疗胰腺癌经验浅析 |
| Experience of SHEN Minhe in Treating Pancreatic Cancer |
| DOI：10.16466/j.issn1005-5509.2022.01.014 |
| 中文关键词: 胰腺癌 消化道恶性肿瘤 扶正固本 用药特色 临床经验 医案 沈敏鹤 名老中医 |
| 英文关键词: pancreatic cancer malignant tumor of digestive tract strengthening the body and supporting healthy energy characteristics of medication clinical experience medical records SHEN Minhe famous TCM doctor |
| 基金项目:浙江省名老中医专家传承工作室建设项目(GZS2020018)；浙江省中医药科学研究基金项目(2022ZB122、2022ZZ013)；浙江省卫生创新人才培养对象(2021-47) |
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| 中文摘要: |
| [目的] 归纳总结沈敏鹤主任中医师治疗胰腺癌的学术经验。[方法] 通过临床跟师学习，对沈师治疗胰腺癌的病案进行整理，从病因病机、治疗特色、辨证论治三个层面介绍其治疗胰腺癌的临床经验，并附医案加以佐证。[结果] 沈师认为胰腺癌的发生发展与脾虚不运、七情郁结、正气不足密切相关，临证重视脾胃、调畅气机、扶正培本，将胰腺癌分为气血亏虚、寒热错杂、脾虚湿阻、气机郁滞四型，气血亏虚型投以八珍汤加减，寒热错杂型以补脾胃泻阴火升阳汤加减，脾虚湿阻型以藿朴夏苓汤加减，气机郁滞投以柴胡剂。沈师反复告诫切勿拘泥于证型，需谨守病机，根据患者实际情况进行辨证论治。所举验案，沈师辨为气机郁滞，治拟疏肝利胆、条达气机，以大柴胡汤加减，取得较好效果。[结论] 沈师治疗胰腺癌注重扶正祛邪，主张灵活辨证，辨病与辨证有机结合，以求阴阳平衡，内外和谐，其学术经验丰富，临证特色突出，临床疗效显著，总结其学术经验对于胰腺癌的治疗有一定指导意义。 |
| 英文摘要: |
| [Objective] To summarize Director SHEN Minhe‘s academic experience in treating pancreatic cancer. [Methods] Through learning from teacher in outpatient， this paper arranged Director SHEN’s medical records of pancreatic cancer and introduced his clinical experience in treating pancreatic cancer from three aspects: Etiology and pathogenesis， treatment features and syndrome differentiation， and provided medical cases as evidence. [Results] Director SHEN believes that pancreatic cancer is closely related to spleen deficiency stagnation of seven emotions and lack of righteousness. In the treatment of pancreatic cancer， Director SHEN pays attention to the spleen and stomach， regulating Qi movement， strengthening and cultivating the body， he divides pancreatic cancer into four types: Qi and blood deficiency type， cold and heat complex type， spleen asthenia and dampness retention type and stagnancy of functional activities of Qi type. Modified Bazhen Decoction is used for Qi and blood deficiency type， modified Bupiwei Xieyinhuo Shengyang Decoction is used for cold and heat complex type， modified Huopo Xialing Decoction is used for spleen asthenia and dampness retention type， Radix bupleuri agent is used for stagnancy of functional activities of Qi type. Director SHEN repeatedly warns not to stick to the syndrome type， but to observe the pathogenesis and treat according to the actual situation of patients with syndrome differentiation. The attached medical record was identified as stagnancy of functional activities of Qi， Director SHEN treated with soothing the liver and gallbladder and promoting Qi activity， modified Dachaihu decoction was used for treatment and good results were achieved. [Conclusion] In the treatment of pancreatic cancer， Director SHEN pays attention to invigorating the body and dispelling pathogenic factors， advocates flexible syndrome differentiation， combination of disease differentiation and syndrome differentiation， so as to achieve the balance of Yin and Yang， internal and external harmony. Director SHEN‘s academic experience is rich， clinical characteristics are prominent， and clinical curative effect is remarkable. Summarizing his experience has certain guiding significance for the treatment of pancreatic cancer. |
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