健脾活血清热法治疗肝癌

吴申++陈挺松++吴孝雄

DOI：10.16662/j.cnki.1674-0742.2017.23.196

[摘要] 肝癌在我国多发，死亡率高。尽管西医占主导地位，有多种治疗方法，但均存在明显局限。中医能有效弥补西医之不足。在西医治疗的基础上，再予中医配合治疗，能进一步提高疗效。肝癌以脾虚、血瘀和热证多见。健脾活血清热法是肝癌常用治法。该文从多方面介绍了脾虚、血瘀和热证的病因病机，对健脾、活血、清热治法进行了详细分析，强调消灭或控制肝脏癌邪是治疗根本，并附验案 1则。

[关键词] 健脾；活血；清热；治法；肝癌

[中图分类号] R273 [文献标识码] A [文章编号] 1674-0742（2017）08（b）-0196-03

Treatment of Liver Cancer by Strengthening Spleen and Activating Blood Circulation and Heat-clearing Method

WU Shen， CHEN Ting-song， WU Xiao-xiong

Department of TCM， Yangpu Hospital Affiliated to Tongji University， Shanghai， 200093 China

[Abstract] Liver cancer is common in China with high mortality. Although western medicine is still dominant， there are many treatments， all of which have obvious limitations. While traditional Chinese medicine can effectively remedy the deficiency of western medicine. Accompanied with the western medicine treatment， traditional Chinese medicine can further improve the curative effect. Liver cancer is characterized by spleen deficiency， blood stasis and heat syndrome. Strengthening spleen， activating blood circulation and clearing away heat are commonly used therapies for liver cancer. This article introduces the etiology and pathogenesis of spleen deficiency， blood stasis and heat syndrome from many aspects. In this paper， the methods of strengthening spleen， promoting blood circulation and clearing away heat are analyzed in detail. This article emphasizes that the elimination or control of liver cancer is the basis of treatment， and the case 1 is attached to the test.

[Key words] Strengthening spleen； Activating blood circulation； Clearing away heat； Therapeutic method； Liver cancer

《2015中国肿瘤登记年报》显示，原发性肝癌（primary liver cancer，简称肝癌）居全国恶性肿瘤发病第四位，死亡第二位，5年生存率为10.1%。大多数由慢性肝疾病发展而来，主要是乙肝或丙肝[1]。在病理组织学上，肝细胞型（Hepatocellular carcinoma，HCC）约占90%。尽管西医有手术切除、血管介入、局部消融、放疗、索拉非尼等多种治疗方法，但均存在明显局限。中西医结合治疗能弥补单一治疗方式的不足，取长补短，进一步提高临床疗效[2]。多数研究表明，中药可通过复杂方式单独或与其他常规疗法相结合来延缓HCC进展，以改善HCC患者的生活质量[3]。据估计，我国80%以上的肝癌患者在不同时间段不同程度地接受中医药治疗[4]。

治法是中医辨证和处方遣药的重要桥梁，直接指导临床药物的优化选择，还可揭示中医疗效的机制。研究肝癌的常见治法，即使复杂、难治病例也有章可循。治法研究应该受到重视，有望成为肝癌中医规范化诊治方案形成的突破口。……