Cancerous ascites is caused by malignant tumors that cause diffuse lesions in the parietal peritoneum of the abdominal cavity, which causes an abnormal increase in fluid in the abdominal cavity. It is a common complication in the late stage of malignant tumors, which can cause abdominal distension, abdominal pain, fatigue, anorexia, difficulty breathing, Clinical manifestations such as restricted activity, circulatory disorders, and multiple organ failure. At present, Western medicine has abundant treatment methods for this disease, but the curative effect is not good. Therefore, we analyze the correlation between cancerous ascites and traditional Chinese medicine phlegm drinking disease, and explore the theory of "sick phlegm drinkers should be warm medicine and harmony" proposed in the "Golden Chamber Synopsis", for the clinical suppression of cancerous ascites The growth of the disease provides new ideas and methods to improve the quality of life of patients and prolong their survival.
1. The relationship between cancerous ascites and phlegm-drinking disease
Cancerous ascites belongs to the category of "bloating disease" in Chinese medicine. "Su Wen · Belly In Theories" says: I am sick and full of confidant, but I can't eat after eating. Why is this disease? Qibo to Japan: It is called bulging.” Bloating disease is closely related to the metabolism of water and fluid. It is caused by the dysfunction of visceral organs and body fluids, which causes water to stop and gather in the abdomen. Therefore, it belongs to the category of phlegm-drinking diseases. Malignant tumor patients may be caused by Tumor obstructs the circulation of qi and blood, or damages the body's right qi due to illness for a long time, or damages the body's yang qi due to radiotherapy and chemotherapy. In the late stage, it shows the phenomenon of yang deficiency. Yang deficiency means yin cannot be transformed, water becomes yin, qi It is unfavorable to dissolve , accumulate in the abdomen, and form cancerous ascites, which is phlegm-drinking disease. Z3z
2. "Sick phlegm drinkers should be treated with warm medicine and harmony"
" Golden Chamber Synopsis ·phlegm cough syndrome It is proposed in "Combination Treatment" that "sick phlegm drinkers should use warm medicine to harmonize them", which means that phlegm drinking is a place where the evils of drinking water are gathered together. The air of cold water hinders the qi machine and the cause is pathogenesis and cancer Sexual ascites are the same, treating as warming yang to cure the root cause, transforming drinks to eliminate the symptoms. Cancerous ascites is yin, a tangible evil, which can spread to the five internal organs, stop gathering locally, and overflow everywhere, ranging from blocking yang to severely hurting people Yang Qi has the characteristics of condensing when encountering cold, acting when encountering Yang, and transforming into warming. Therefore, it should be warmed to replenish Yang Qi, so that Yang can be transported and transformed, and the evil will be eliminated by drinking.
1, distinguishing "warming medicine"
generally believes, " "Warm medicine" refers to medicines with warming properties, including sweet and warm, bitter and pungent temperatures. Sweet and warm medicines can tonic, harmonize, reconcile the medicinal properties, relieve pain, and relieve pain. The bitter and warm medicine can dry dampness, help yang and transform qi, and the power is to damp dampness to dissolve the drink; the pungent and warm medicine can promote yang, promote qi and promote blood, and the power is to provide a way out for drinking evil.
"Synopsis of the Golden Chamber" The main prescriptions listed for the treatment of phlegm-drinking diseases are Lingguishugan Decoction, Wulingsan, Shenqi Pill, Xiaobanxia Decoction, Xiaoqinglong Decoction, etc. The main medicines are Poria , Guizhi, Atractylodes, Pinellia, ginger, and fine Xin, etc., are all medicines with warm-heat properties, among which Guizhi and Poria are the cores. Guizhi can warm the yang and improve the pulse, help yang and transform qi, and aim at the pathogenic elements of phlegm-drinking diseases that cause qi disharmony and qi loss. Poria cocos are sweet, light and calm in nature, and can invigorate the spleen with sweetness, restore the spleen's function of transporting and transforming water and dampness, light can penetrate dampness, so that dampness has a way out. The combination of Gui and Ling can invigorate the yang of the whole body. Develop the principles of physiology and unblock the water channels. The evil of phlegm and drinking will help the yang to start the movement, and the warm medicine will start to start, the yang qi will move the water and the water will move, and the warm medicine will turn the evil into the drink.
2, distinguish "harmony"
Jiezi" says "harmony, corresponding." "Guangya" says "harmony, harmony." Lao Tzu's Tao Te Ching says: "Everything bears yin and embraces yang, and urges for harmony. "It can be seen that "he" is the state of yin and yang corresponding, and Yin and Yang are secreted. Zhang Zhongjing took the word "he" as the principle of treating phlegm-drinking diseases, and intended to emphasize that the treatment of phlegm-drinking diseases should be based on the characteristics of the patient’s disease. , Disease changes, physical endowments, etc., adopt corresponding comprehensive methods to help patients maintain a state of "yin and yang peace". Use warm medicine but do not blindly warm up, avoid cold and dampness, induce phlegm and fire again, and can act as appropriate to eliminate , Enlighten, and lead the product, promote the qi, eliminate the phlegm, open the yang, guide the evil spirits from the urine and feces, supplement the yang with warmth, and drink the water. The condition of patients with cancerous ascites is complex and changeable, and the emergency causes When the amount of ascites is large, breathing difficulties, lack of food, abdominal distension, wheezing and restlessness, etc., this is when the water evil is at its peak, when supplemented with diuretic methods, first eliminate the evil to calm the righteousness, and then try to improve the righteousness. Restoring peace.
3. Treatment methods based on warm-yang thinking
1, warming kidney yang , replenishing the yang qi
kidney governs water, stores essence and receives qi, and all water-related diseases are related to the kidney. In the normal process of water and fluid metabolism, the turbid fluid produced by the metabolism of the viscera and body organs is transferred to the kidney through the triple-joule waterway, and then divided under the action of the kidney’s gasification.Clear turbidity, and eventually form urine to excrete from the body. The essence and qi in the kidney transform into kidney yin and kidney yang. The yang qi of the whole body is governed by the kidney yang. It has the functions of warming, pushing, excitement and dissipating qi. It can promote the metabolism of the human body and transform the water and body fluid into qi, For energy.
Patients with cancerous ascites are mostly late in the course of the disease, with damage to the internal organs, and the amount of turbid fluid produced by metabolism is large and fast. However, the kidneys are also damaged at this time, which seriously affects their water metabolism, causing the water to stop gathering in the abdomen. If you don't score clear up to the lungs, and you can't lower the turbidity, bet on the bladder . More in and out, ascites are increasing day by day, which further affects the function of viscera. In addition, the body of tumor patients is yang deficiency, and cancerous ascites is yin and evil which hinders the kidney yang. The combined effect of the two makes the kidney yang deficiency and weakening of qi. When the patient also has symptoms such as dark complexion, back pain, cold limbs, etc., it may indicate the existence of kidney-yang deficiency. Deficiency of kidney yang will slow down the body's metabolism, damp the body and stop internally, the body will not produce enough heat, and the spirit will be weakened, making the condition worse. Therefore, attention should be paid to warming and nourishing the kidney and yang, opening and diverting water channels, so that the water has a way out and reducing ascites. At the same time, it mobilizes the patient's spirit and enhances the ability to resist evil by invigorating Yang Qi.
2, warming the spleen and yang, dispersing moisture
spleen has the physiological function of transferring the water absorbed by the gastrointestinal tract to the lungs; the water transferred to the lungs is again cleared and turbid, under the dispersing action of the spleen or from the muscle holes Orifices may be excreted with urine and sweat. Therefore, whether the water can dissipate the body fluid through the body depends on whether the temper is normal.
The function of spleen to transport and transform water is reduced, which will inevitably lead to the accumulation of water in the human body, resulting in pathological products such as water, dampness, phlegm, and drinking. As stated in "Su Wen · Zhi Zhen Yao Da Lian Pian": Dampness and swelling belong to the spleen." If the dampness does not decompose, the spleen yang is trapped and the yang cannot grow, the spleen's dysfunction in transporting and dissipating dampness will aggravate the accumulation of phlegm and drinking dampness, resulting in a vicious cycle of spleen yang. Therefore, it is necessary to invigorate the spleen yang during treatment and restore the spleen's transport and chemical functions.
Patients with cancerous ascites tend to lose appetite, lack of appetite, fatigue, chills and fear of cold, all of which are due to insufficient spleen yang. Clinically, dried ginger and Atractylodes macrocephala are used to warm and nourish the spleen and yang. The book "Seeking Truth in Materia Medica" says that dried ginger is "hot and non-toxic, and keeps it without going away". Modern pharmacological research has also shown that Baizhu can regulate gastrointestinal motility, diuresis, enhance immune function, and can significantly inhibit the proliferation of cancer cells, and has anti-tumor effects. Dried ginger also has pharmacological activities such as enhancing immunity and anti-tumor. The combination of the two drugs has the effect of warming the spleen and yang.
3. Warm the bladder, make the water vaporize into the body fluid through the joint action of the lungs, spleen, kidneys and other organs to spread throughout the body. The bladder turns into urine and comes out to complete the process of human body water transportation. Cancerous ascites patients with abdominal distension are difficult to manage, many days of bed rest, calmness is yin, the body is insufficient yang, and ascites oppresses the bladder, the bladder feels yin evil, resulting in deficiency and cold. Clinically, it can be seen that patients have urgency, frequent and clear urination, and inexhaustible dripping. If the bladder is not warm, the gasification function will be weakened, the water will have no way out, and it will be occluded in the body, which will cause solidification and weakness, abnormal urine storage and urination, which will aggravate ascites and worsen the condition.
At present, Western medicine mostly treats cancerous ascites by peritoneal circulatory hyperthermic perfusion, which is to heat a large volume of perfusate or perfusate containing chemotherapeutic drugs into the abdominal cavity continuously at a constant temperature, and remove the lesions through thermochemical synergy and scouring. Studies have shown that compared with traditional intraperitoneal perfusion chemotherapy, the use of intraperitoneal circulation hyperthermic perfusion chemotherapy to treat malignant ascites can achieve significant short-term benefits, so that cancerous ascites can be better controlled. From the perspective of traditional Chinese medicine, "thermal perfusion" is the process of "warming the bladder". The patient's abdominal yin water accumulates. With the help of thermal perfusion therapy, the body's yang energy is rejuvenated and the bladder is warmed, thereby exerting a normal diuretic effect. In addition, the bladder and the kidney are on the outside and inside, and warming the bladder can also warm the kidney, so that the innate roots can be sheltered.
4, warming the heart and yang, promoting blood and water
The heart is fire in the five elements, and the sun in the sun. The heart's yang heat not only maintains the heart's own physiological functions, but also warms the whole body and promotes blood circulation throughout the body. If the heart yang is insufficient and the warmth is weak, the human body's spirit will be weakened and the consciousness will be lost. The heart also governs the blood vessel, and its main blood vessel function declines, which will cause cold to enter the blood, the blood flow is not smooth, the blood stasis is blocked, and it accumulates over time. "Jingyue Quanshu·Swelling Chapter" Day: "Anyone who is sick with water is the blood gas in the body." The "Golden Chamber Synopsis" discusses the pathogenesis view of "water if the blood is unfavorable". It turns into water, and water and blood stasis are both evils of yin. The subtle substance of body fluid enters the veins as blood, and travels outside the veins as water. Both have the same source but different forms. Based on this, it can be inferred that the production of ascites is related to StasisClose blood relationship. Patients with
malignant tumors generally have a hypercoagulable state. Modern medicine believes that it may be related to tumor cells inducing platelet aggregation, strong tumor blood vessel permeability, and long-term use of chemotherapy drugs. However, Chinese medicine believes that the patient's clinical manifestations such as dark purple tongue, thin and astringent pulse, and prominent abdominal veins are signs of blood stasis. In patients with malignant tumors, after chemotherapy and radiotherapy, yin and fluid are darkly depleted and blood nourishment is insufficient, or tumors in the body block the circulation of qi and blood, or the body fluid is insufficient to carry blood, and eventually the blood flow is not smooth and stasis occurs. Most of these patients have heart palpitations, chest tightness, cold form, fatigue and other symptoms. The treatment for this is to remove blood stasis and promote blood. The key to removing blood stasis and promoting blood is to warm the heart and Yang. In clinical practice, Guizhi and attached tablets are commonly used to warm and nourish the heart yang, inspire the mental activity of patients, improve the body's defense capabilities, and make water travel with the blood.
Zhang Zhongjing puts forward "warming medicine and harmony" as the general principle of phlegm-drinking disease treatment, emphasizing that in the dynamic process of treatment, it is necessary to replenish the body's yang and restore the normal flow of water. This idea can guide the treatment of cancerous ascites. Specific to different conditions, by warming the kidney yang, spleen yang, bladder, heart yang, and also using the method of diuresis, it can relieve the symptoms of ascites while improving the deficiency of Yang Qi in cancer patients. In addition, in the treatment of this disease, it is often used to attack Zhulishui. At this time, it must be supplemented with products that support righteous qi to avoid excessive consumption of righteous qi and lay the foundation for subsequent treatment. This is also the principle of "warm medicine and harmony". reflect.
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