中医杂志

总结刘尚义教授从“引疡入瘤”辨治直肠癌的临证经验。认为直肠癌所见的肛门瘙痒，菜花样、溃疡形态的肿物，便血与外在的皮肤瘙痒，皮肤破溃、疡肿，皮肤出血等症状相似，故可将疮疡科治则运用于肿瘤治疗。针对临床典型症状遵循疮疡科诊疗思路，肛门瘙痒治以祛风除湿、清热止痒为主，选用地肤子、白鲜皮等“肤药”及升麻、防风等风药；大便干结予清热解毒、通腑泻热之法，常用白头翁、冬凌草、大黄等；黏膜溃疡辨阴阳，阳疮侧重清热解毒，常用仙方活命饮加减，阴疮注重祛湿化痰，常用薏苡附子败酱散加减；便血辨虚实，实证以地榆、槐花凉血止血，虚证取二者炒炭并配伍补肝之品。

This paper summarizes the experience of professor LIU Shangyi in differentiating and treating rectal carcinoma from the perspective of "treating ulcers as tumors". It is believed that the manifestations of rectal cancer, such as anal itching, cauliflower-like or ulcerative tumors, and bloody stools, are similar to external skin itching, skin ulceration, swelling, and skin bleeding. Therefore, the treatment principles of sores and ulcers department can be applied to treat tumors. Following the diagnostic and treatment approach of dermatology regarding the clinical typi-cal symptoms, for anal itching, the main treatment is to dispel wind and remove dampness, clear heat to relieve itch-ing, using "skin medicinals" such as Difuzi(Fructus Kochiae) and Baixianpi(Cortex Dictamni), as well as wind medicinals such as Shengma(Rhizoma Cimicifugae) and Fangfeng(Radix Saposhnikoviae). For constipation, the method of clearing heat and resolving toxins, unblocking the bowels and discharging heat can be used, commonly us-ing Baitouweng(Radix Pulsatillae), Donglingcao(Herba Rabdosiae Rubescentis) and Dahuang(Radix et Rhizoma Rhei). In terms of mucosal ulcers, it is critical to differentiate between yin and yang; the treatment of yang ulcers should focus on clearing heat and resolving toxins, commonly using modified Xianfang Huoming Beverage (仙方活命饮);for yin ulcers, emphasis should be placed on removing dampness and resolving phlegm, commonly with modified Yiyi Fuzi Baijiang Powder (薏苡附子败酱散). For bloody stool, differentiation is made between deficiency and excess, with the use of Diyu(Radix Sanguisorbae) and Huaihua(Flos Sophorae) for excess syndrome to cool and stop bleeding, and both herbs dry-fried until charred combined with liver-tonifying medicinals for deficiency syndrome.