刘泽银 周伟康 刘家祺

摘要：本文介绍俞云教授运用切脉针灸治疗原发性肝癌的经验。俞教授认为肝癌总体病机是脏腑亏损，癌毒盘踞，故提出以扶正祛癌为治疗原则，从多个脏腑、经络调节。俞教授基于《内经》理论，创切脉针灸的方法，取四部脉（寸口、人迎、冲阳、太溪），通过切脉，比较4个部位脉的大小、强弱、滑涩、疾徐（数或缓），治疗时对大、强、数脉用泻法，小、弱、缓脉用补法。选穴注重由头面部、腹部、胁部、下肢穴位组成主穴；针刺时根据经验，使用金针补、银针泻作为补泻手段，用以调整全身脏腑、经络气血阴阳，通达肝经，活血祛瘀、行浊化湿，以攻逐肝区癌肿；再根据患者具体症状及病情缓急，辅以相关配穴，达到扶正攻癌目的。

关键词：名医经验；俞云；切脉针灸；原发性肝癌

DOI：10.3969/j.issn.1005-5304.2018.09.028

中图分类号：R273.57 文献标识码：A 文章编号：1005-5304（2018）09-0114-03

Abstract： This article introduced the experience of Professor YU Yun in treating the primary carcinoma of liver by using acupuncture after pulse diagnosis. Professor YU thinks that the overall pathogenesis of liver cancer is deficiency of zang-fu organs， so the cancer cells can invade and occupy in the liver. Therefore， Professor YU uses the way of supporting the healthy qi and driving out the cancer as the treatment principle from multiple organs and meridians. On the basis of the theories of Nei Jing， Professor YU creates the acupuncture after pulse diagnosis. He feels the pulse on the basis of four pulses： Cunkou， Renying， Chongyang， and Taixi. According to the feelings of the pulses， he compares the size and speed， strong or weak， smooth or nonfluency of the four pulses. In treatment， he uses reducing method when the pulse is strong and fast， and tonic method when the pulse is weak and slow. He chooses the main acupuncture points on head， face， belly， flank and lower limbs. According to the experience， Professor YU uses gold needle in tonic method and uses silver needle in reducing method. In this way， the acupuncture after pulse diagnosis can regulate zang-fu organs and meridians， yin and yang， qi and blood， and promote blood circulation for removing blood stasis and resolving dampness， and attack the retained fluid and tumour in the liver， and combined with adjunct points to treat cancer.

Keywords： experience of famous doctors； YU Yun； acupuncture after pulse diagnosis； primary carcinoma of liver

原發性肝癌与多种因素有关，早期可有食欲减退、脘部闷胀等症；中晚期临床表现为右上腹隐痛，持续性或间歇性疼痛，右上腹肿块、乏力、消瘦、发热及水肿、黄疸、腹水、皮肤瘙痒，或出血等。广东省中医院主任医师俞云教授长期从事中西医医疗工作，尤擅长运用切脉针灸治疗疑难杂症，方法独特有效。现将俞教授治疗原发性肝癌经验介绍如下。

1 病因病机

俞教授认为，肝癌病因病机复杂，多由脏腑气血亏虚，情志失调，饮食不节，邪毒侵犯，以致气滞、血瘀、湿邪、痰浊等互结于肝，日久正气愈亏，聚而为积、癌毒盘踞，成为复杂之证。其病位在肝，涉及心、脾、肺、肾及六腑，与胆关系密切，《素问·刺禁论篇》云：“脏有要害，不可不察。……