吕英教授立足“气—元论”治疗儿童肿瘤的经验总结

发布时间：2018-04-08 09:12

本文选题：吕英　切入点：气一元论　出处：《南方医科大学》2017年硕士论文

【摘要】：目的儿童肿瘤包括实体瘤和血液系统肿瘤两大类,是威胁儿童生命健康的主要疾病。目前现代医学常用的治疗方法包括手术、化疗、放疗和造血干细胞移植等。吕英教授为李可中医药学术流派国家传承基地主任,临床擅用纯中医的方法防治儿童肿瘤。因此,本文通过系统整理吕英教授立足“气一元论”治疗儿童肿瘤的经验,总结出一套对治儿童肿瘤,提高患儿生存质量的中医治疗方法。方法首先通过阅读参悟吕英教授出版的专著,搜集整理各类专业期刊和研讨会所发表的论文和讲座课件,以及未发表的文稿及诊疗医案,总结常用的方药及其药物配伍机理,掌握其学术精髓(六气为一气的变现)及辨证方法。其次,通过临床跟诊,学习导师参悟医理的方法:运用天地规律、生命规律、疾病规律,透过现象抓本质,运用“逐症分析,由博返约”将复杂的症状约为六经辨证,体现出了“以病机统万病,执万病之牛耳”的中医治病捷径。最后通过逐症分析临床病例来验证其学术经验。结论吕英教授立足“气一元论”,从元气、中气、萌芽、三阴三阳来论治儿童肿瘤。其近30年临床实践表明:儿童肿瘤的主要病机是患儿先天禀赋元阳不足,冰伏三阴,寒热虚实夹杂,六气绞结成形导致五脏六腑气机升降出入乖乱。故在临床治疗中医者不可只着眼于疾病本身,更需注重的是患儿正气之多少。临证时需分清主次、轻重、缓急,时刻顾护患儿的元气、中气、萌芽。因小儿总体的生理特点为“心肝常有余,肺脾肾常不足”,对应临床就是少阳升发之力强盛,而土气偏不足,加之部分儿童肿瘤可表现出三阴热化到阳明界面的火热燥,故临床治疗中见到各种火热燥时,需要先厘清火热燥的来源,不可妄用凉药,恐折杀萌芽,伤及阳根。因“三阴统于太阴”、“阳明之燥热永不敌太阴之寒湿”,故可利用“治太阴,保少阴”之法,通过健运中气,厚土伏火,恢复患儿自身的圆运动;而当生死关头,阳气将亡,又必须以回阳救逆为急,则可选用李可老中医的破格救心汤;若出现阴竭时则需用引火汤导龙归海,引火归原;若出现胃气将绝,必先救胃气为急,则可选用理中汤、四君子汤等方药。讨论儿童肿瘤作为威胁儿童健康的头号杀手,其发病机制大多尚不明确,中西医均无疗效确切的治疗手段,吕英教授立足“气一元论”用纯中医的方法来论治各种儿童肿瘤虽然取得了可喜的临床效果,但因病例总数及患儿个体差异的限制,其学术经验还只能供部分经验丰富的中医师作为临床参考,难以形成明确的儿童肿瘤临床中医诊疗方案。如何更好的将吕英教授立足“气一元论”治疗儿童肿瘤的学术经验系统化、规范化,以便更好地在临床推广,将是我们需要更长时间来研究的课题。
[Abstract]:Objective Children's tumors include solid tumors and hematological tumors, which are the main diseases threatening children's life and health.At present, the commonly used treatments in modern medicine include surgery, chemotherapy, radiotherapy and hematopoietic stem cell transplantation.Professor Lu Ying is director of the National inheritance Base of Li Ke academic School of traditional Chinese Medicine.Therefore, this paper summarizes a set of traditional Chinese medicine treatment methods for treating children's tumors and improving their quality of life by systematically sorting out Professor Lu Ying's experience of treating children's tumors based on Qi monism.Methods by reading the monographs published by Professor Lu Ying, we collected and sorted out the papers and lecture courseware published in various professional journals and seminars, as well as the unpublished manuscripts and medical records of diagnosis and treatment, and summarized the commonly used prescriptions and their compatibility mechanism.Master the essence of its academic (six Qi for the realization of one Qi) and dialectical methods.Secondly, through clinical follow up, the method of learning tutors' participation and understanding of medical principles: using the law of heaven and earth, the law of life, the law of disease, grasping the essence through the phenomenon, applying "analysis by symptom," making the complex symptoms about syndrome differentiation of the six meridians by "returning to the covenant".It reflects the short-cut of Chinese medicine to cure the disease with the pathogenesis of the disease and the ear of the cow with the disease of ten thousand diseases.Finally, its academic experience is verified by symptomatic analysis of clinical cases.Conclusion based on Qi monism, Professor Lu Ying treats childhood tumors from Qi, Qi, germination and Sanyin and Sanyang.The clinical practice in recent 30 years shows that the main pathogenesis of children's tumor is the deficiency of congenital endowment of Yuanyang, the cold and the three yin, the inclusion of cold and heat, and the formation of six-gas strangulation, which leads to the disorder of the movement of organs and organs.Therefore, in clinical treatment, the doctor should not only focus on the disease itself, but also pay more attention to the number of healthy children.Clinical needs to distinguish between primary and secondary, light and urgent, care for the child's vitality, midair, germination.Because the overall physiological characteristics of children are "heart and liver are often more than, lung, spleen and kidney are often insufficient," the corresponding clinical is that the strength of small yang rising is strong, and the earth qi is insufficient. In addition, some children's tumors can show fire and dryness from the heat of three yin to the interface of Yangming.Therefore, when we see various kinds of hot dryness in clinical treatment, we need to clarify the source of hot dryness first.Because "three yin is unified in Taiyin" and "the heat of Yang Ming never fosters the cold and dampness of Taiyin", the method of "treating Taiyin and protecting little yin" can be used to restore the child's round movement through healthy transportation of midair, thick earth and fire, and when the moment of life or death comes to an end, Yang Qi will die.If it is urgent to return to the Yang and save the adverse, you can choose Old Li Ke's decoction to save your heart. If you run out of yin, you will need to use fire soup to lead the dragon back to the sea, and the fire will go back to the original. If there is a stomach qi, you must first save the stomach qi as a hurry, then you can choose the Lizhong Tang.Sijunzi decoction and other prescriptions.It is discussed that children's tumor is the number one killer threatening children's health, and the pathogenesis of it is still unclear, and there is no effective treatment method in both Chinese and western medicine.Professor Lu Ying based on "Qi monism" used pure Chinese medicine to treat all kinds of children's tumors, although they have achieved gratifying clinical results, they are limited by the total number of cases and the individual differences of children.Its academic experience can only be used as a clinical reference for some experienced TCM doctors, and it is difficult to form a definite clinical diagnosis and treatment scheme for children's tumor.How to better systematize and standardize Professor Lu Ying's academic experience in treating children's tumor based on "Qi monism", so as to popularize it better in clinic, will be a subject that we need to study for a longer time.
【学位授予单位】：南方医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R249;R273

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