陈炽炜 王峻 陈铭

摘要：崔学教教授认为，前列腺癌病机乃正气虚弱、脏腑虚衰；起病之源是七情所伤，饮食不节；成病之所是瘀毒久积，结于下焦。临证强调通法的应用，重视局部与整体、扶正与祛邪及个体化分期分症用药。治以行气活血、化瘀散结、清热解毒为法，结合扶正与疏肝，取得较好疗效。

关键词：名医经验；崔学教；前列腺癌；辨证论治

DOI：10.3969/j.issn.1005-5304.2018.07.026

中图分类号：R273.7 文献标识码：A 文章编号：1005-5304（2018）07-0105-03

Abstract： Professor CUI Xue-jiao considers that the root of prostate cancer is qi weakness and internal organs failure； the TCM pathogenesis of prostate cancer is seven emotions wounds and improper diet； the focus of prostate cancer is stasis blocking and poison collecting in lower energizer. Professor CUI attaches great importance to the method of purging therapy， emphasizes the part and the whole， strengthening body resistance to dispel pathogenic factors， and choosing different medicine based on different stages. Therapy mainly includes promoting qi and activating blood， resolving stasis and softening hardness， clearing heat and removing toxicity， strengthening healthy energy and soothing the liver， with good efficacy.

Keywords： experience of famous doctors； CUI Xue-jiao； prostate cancer； syndrome differentiation and treatment

广州中医药大学第一附属医院主任医师崔学教教授是第三批全国名老中医，从事医、教、研40余载，临证融合贯通中西医理论，将辨病与辨证、整体与局部、理论与实践相结合。笔者有幸跟师学习，受益匪浅。兹将崔教授诊治前列腺癌经验介绍如下。

1 病因病机

1.1 正气虚弱、脏腑虚衰为发病之根

流行病学研究显示，前列腺癌患者主要为老年男性，中位年龄72岁，高峰年龄75～79岁；在我国，小于60岁的男性发病率较低，超过60岁则明显增长[1]。崔教授认为，前列腺癌与年龄、正气密切相关。年老则肾虚无以蒸腾温煦脏腑，加之气血津液皆不足，故诸脏易受外邪侵袭。《素问·上古天真论篇》云：“丈夫八岁肾气实，发长齿更……五八肾气衰，发堕齿槁……八八天癸竭，精少，肾脏衰，形体皆极，则齿发去”，又“肾者主水，受五脏六腑之精而藏之，故五脏盛，乃能泻。”崔教授认为，正气虚弱的根本内因在于元气虚弱及脾气虚弱两方面。随着年龄增长，肾中元气逐渐亏虚，无以气化水液，温煦脏腑经络，以致痰饮、瘀血等病理产物停留体内，加之虚邪贼风侵袭而致病。