郭勇教授辨治肝癌经验探析

摘要

[Objective]To explore the clinical experience of Professor GUO Yong in treating hepatocellular carcinoma. [Methods] Through studing Professor GUO Yong's academic papers and books,listening to his teachings and collecting,analysing typical medical case,and exploring and discussing his treatment of tumor thinking, its characteristics and syndrome differentiation laws,summarizing their academic thoughts and clinical experience, and analyzing typical cases in his treatment. [Results]Professor GUO Yong holds that the disease's root is deficiency of Zang Fu organs,and its branchis the mutual cementation of Qi and blood, liver depression, stagnation of Qi, stasis of blood and the interaction of exogenous poison or endogenous pathological products,meanwhile advocates attention to the spleen and stomach, qi and blood, regarding smooth as a fundamental,Chinese and western medicines working together to treat diseases,clearing primary and secondary changes in the different stages of traditional Chinese medicine treatment and modern treatment, and according to the different syndromes and treatment purposes in different stages of liver cancer treatment,phasing the treatment;attention to the impact of TCM syndromes such as, perioperative surgery, anesthesia and other factors, and correctly join the treatment of Chinese medicine to improve the rate of radical surgery succession,at the same time pay attention to the syndrome and syndrome differentiation combined to reduce tumor recurrence and metastasis in follow-up period,tumor free state.[Conclusion]Professor GUO Yong's unique insights and rich clinical experience in treatment of primary liver cancer is worth learning and promotion.%[目的]探讨郭勇教授辨治肝癌的临床经验.[方法]通过侍诊中聆听郭勇教授关于现代医学治疗对患者中医证候影响的分析及理、法、方、药的思路讲解,总结郭勇教授辨治肝癌的观点、临床经验及其独到之处,并通过案例具体说明.[结果]郭勇教授认为肝癌以脏腑气血亏虚为本,肝郁、气滞、瘀血、痰湿热毒与外来毒邪或内生病理产物交互胶结为标.治疗上主张围手术期中药处于配合手术的角色,辅助期及随访期当以中医药治疗为主导地位,而姑息治疗期则视患者体质情况决定中、西医的主次关系;重视围手术期手术的耗气散血,术前心理或麻醉影响气机畅达对患者证候影响,同时正确加入健脾、扶正、理气等作用的中药来提高根治性手术的通过率、切除率;重视随访期无瘤状态下的辨体质与辨证结合施治,以降低单纯现代医学治疗下此期的肿瘤复发转移率.[结论]郭勇教授治疗原发性肝癌的中医精准治疗论,四阶段论,中、西关系主次变化观等等具有丰富而独特的思想内涵,且有着丰富的临床经验,值得学习、推广.