张亚强治疗膀胱癌临床经验

膀胱癌是泌尿外科常见疾病,现代医学主要采用手术治疗,以及术后常规膀胱灌注化疗药物。中医药能够降低膀胱癌术后复发率及降低化疗药物引起的不良反应。张亚强认为膀胱癌病位在膀胱,涉及脾肾,属于本虚标实。本虚为脾肾亏虚、气血不充,标实为湿热、热毒、痰浊、瘀血。基本病机多为脾肾亏虚、湿热蕴结、痰瘀毒互结,遇正气不足时适时复发。故在治疗过程中应重视预防复发,临证中注重病证症结合、分期论治,权衡驱邪与扶正力度,重视脾胃功能以及气机的条畅。根据临床经验并结合膀胱肿瘤特点创制消癥汤,药物配伍体现了中医扶正培本、祛邪不伤正的原则,临床证明可有效预防膀胱癌患者术后复发。

Clinical Experiences of ZHANG Yaqiang in Treating Bladder Cancer

Bladder cancer is a common disease in urology. The main method is operation in modern medicine and using intravesical instillation of chemotherapeutics. Chinese medicine can prevent the recurrence of bladder cancer after operation and reduce the side effects of chemotherapeutics. ZHANG Yaqiang regards that the disease locates in the bladder,involving the spleen and kidneys,belonging to root deficiency and branch excess. Root deficiency includes spleen-kidney insufficiency,Qi and blood insufficiency. Branch excess includes damp-heat,toxic heat,phlegm and blood stasis. So the basic pathogenesis of bladder cancer is insufficiency of the spleen and kidneys,the accumulation of damp and heat,the retention of phlegm,blood stasis and toxicity which causing the recurrence in case of healthy Qi insufficiency,So in the clinic we should focus on the recurrence,combine the symptoms,disease and syndrome,differentiate the stages. Attention should be paid to the conditions of healthy Qi and pathogenic factors,the functions of spleen and stomach and the smoothness of Qi circulation. Xiaozheng decoction with the functions of supplementing the healthy Qi and dispelling the pathogenic factors should be used to prevent the recurrence of bladder cancer after operation effectively in the clinical practice.