2020/02Ⅰ 49

于防止进一步的神经损伤。

在难以治疗的情况下，疼痛专家可以使用侵入性

或可植入设备来有效管理疼痛。参与神经性疼痛的神

经的电刺激可显著控制疼痛症状。针灸治疗神经性疼

痛有非常显著的疗效。

本文重点介绍糖尿病足的针灸治疗。糖尿病足

病的主要症状是下肢疼痛及皮肤溃疡。在早期，双脚

会感觉皮肤瘙痒，怕冷，发白或发紫，肢端刺痛，麻

木，感觉迟钝或丧失，走路像踩在棉花上一样，进而

在行走时突然出现下肢疼痛，必须休息一会儿才能继

续行走；后来，往往会足部皮肤溃烂、坏死，创口久

久不愈，坏死可深入肌腱、韧带以及骨头，最终病人

不得不接受截肢手术而导致残废。

针灸治疗糖尿病足，根据其临床特征性表现来进

行取经络和穴位。比如，间歇性跛行通常发生在病变

早期，具体表现为行走一段距离后，突然出现臀部、

大腿、小腿肌肉麻木、疼痛，以至于痉挛或跛行，严

重者甚至需要蹲下休息，等症状完全消失后才可继续

行走。中医辨证多为气滞、风寒邪阻滞经络，根据疼

痛所在或接近的经络和穴位进行局部针刺，根据患者

的体质，用稍重或疏泄的手法行针刺激以疏通经络，

臀部要取环跳穴为主穴。患者在接受针刺环跳穴时局

部疼痛的立刻缓解，并有传至下肢体的传导感应。细

节上要考虑到准确取穴，针刺的深度和角度，刺激的

量和传导，以及针刺入穴位后，患者的症状有明显的

缓解甚至完全消失。同时，有大腿症状的加刺风市

穴，膝阳关穴或承扶穴，殷门穴和委中穴。有小腿症

状的加刺阳陵泉穴和飞扬穴、悬钟穴等穴位。另外，

效果的差异还体现在手法上的差异。

休息疼痛通常发生在疾病的中间，表现为脚趾或

脚趾末端处于安静状态时的疼痛，躺下时尤其是在晚

上，疼痛更明显，需要采取一些步骤减轻它。在传统

中医中，表现为血管的血瘀阻滞，经络的痰湿阻滞，

关节发红、肿胀、热痛。这个时期的治疗需要针灸和

药物的结合。在治疗疼痛的同时，有必要改善血管、

经络和关节的循环以消除瘀滞。根据相邻的经络和穴

位选择穴位。总之，有必要考虑降低血糖，消除血瘀

肿胀，减轻体重和腹部。充分利用针灸和中药对病因

进行综合治疗，在治疗一周内，患者的血糖水平、肿

痛、体重和四肢周围循环能得到明显改善，长期治疗

可以控制和治愈糖尿病足。

糖 尿 病 足 案 例 ： 糖 尿 病 患 者 病 程 长 （ > 1 0

年），伴白蛋白尿和/或估算肾小球滤过率 (estimated

glomerular filtration, eGFR) 降低，如没有其他肾损伤

原发病因的体征或症状，则通常可临床诊断糖尿病肾

病 (diabetic kidney disease, DKD)。一些症状直到疾病

晚期才出现，例如乏力、厌食以及肢体水肿。体征包

括高血压、水肿和微血管并发症（糖尿病视网膜病变

和神经病变）。在这种情况下，如何用针灸治疗来改

善肾功能，提高GFR，改善视力，并改善四周肢体循

环呢？A先生，65岁，因血糖失控，长期在10以上，

高血压服用利尿药导致肾功能损伤，GFR低于60（正

常大于60），同时有痛风、糖尿病足、红肿疼痛、视

力下降。针灸取穴：调理脾胃运化痰湿，泻天枢、阴

陵，补商丘、公孙增益脾阳，太冲疏通气机，并结合

足部局部穴位，来诊所治疗仅一年多，血糖控制非常

好，HA1c指标下降，GFR明显改善到68。痛风消失，

糖尿病足疼痛在一个星期内缓解，下肢水肿消失。针

灸治疗让他非常满意！

结束语：在美国约有一千万个糖尿病患者，而足

部疾病是百分之二十糖尿病患住院治疗的主要原因，

且下肢毛病是最常见而需要手术的疾病。大约三分之

二非创伤性下肢截肢发生在糖尿病患者身上。据数据

统计，糖尿病患者下肢的截肢率是非糖尿病患者的40

倍，约15%的糖尿病患者会在一生中发生足溃疡。另

外，糖尿病足溃疡还可并发或诱发其他急性心脑血管

事件，甚至诱发糖尿病急性并发症，如酮症酸中毒、

高渗性昏迷、全身脓毒症等，直接威胁到患者的生

命。对于糖尿病足的问题，绝不可忽略。介绍和推广

针灸治疗糖尿病足，极大地降低糖尿病足的发病率和

减少政府医疗费用，是一件利民利国的好事，希望能

引起相关专业人士和患者的高度重视。

（作者为加拿大医学博士 ）

Clinical practice of acupuncture treatment｜针炙实战

50 Ⅰ2020/02

临床名医｜Clinic Specialist

Thoughtson the New Coronavirus Plague.

◎ caodongyi yizhe/zhangfengrong chensirong

After the outbreak of the COVID-19 plague,

General Secretary Xi personally deployed and directed

himself. At the Political Bureau meeting on the first day

of the first month in Chinese Lunar Calendar (January

25), he decided to adopt the mode of cooperation between

Traditional Chinese and western medicine to treat patients.

Traditional Chinese Medicine personnel quickly entered

the main battlefield and overcame many difficulties

including the lack of reserves of herbal medicine, not

being understood by patients and western doctors and etc.

Traditional Chinese Medicine soon played a great role,

achieved obvious good results. Not only in mobile cabin

Hospital, which supposed to be full of panic and grief, the

herbal fragrance is floating in air, the doctors and patients

practice the Ba Duan Jin constantly, even the person who

discredited TCM in the past has also been rescued by

Traditional Chinese Medicine, defeating COVID-19 to

regain his health.

China’s cooperation between Traditional

Chinese and western medicine rescue model got highly

estimates form WHO expert, he sincerely said that if he

unfortunately infected, also hope to come to China for

treatment. I think he definitely does not envy the ventilator

of ICU in China, but likes the atmosphere and medical

effect of mobile cabin hospital.

TCM as “ the first and required choice ” has

become an unprecedented reality

In the past, the treatment methods of Traditional

Chinese Medicine are listed in the last as one of the

alternative treatment measures, only play the role of

supplement or replacement. There never has a “Diagnosis

and Treatment Guide” to put the Traditional Chinese

Medicine to the prominent position as first choice and

required treatment. But this situation changes in COVID19’s treatment. The participation rate and utilization

rate of TCM, the ratio of patent Traditional Chinese

medicine to herbal soup, have been directly brought into

the investigation index. Even these indexes have the

value of “one vote veto”. Where the TCM rescue rate

is low, the work there will be considered as passive and

become the target of public criticism. According to data

released by the Hubei Provincial Health Commission on

February 12, 2020, the participation rate of TCM was only

30%. This result immediately sparked an uproar, even

though the most elite western medicine experts in China

gathered there. The situation of eagerly looking forward

to Traditional Chinese Medicine has never appeared in the

past, but now it has all of a sudden become a life-saving

fashion and the popularity of the Internet. Moreover, in

a concentration of tens of thousands of patients, some

experts who hope to practice scientific experiments of

western medicine and import western medicine, even not

be able to gather the certain number of people observed

in groups. This is something they did not expect. It can be

said that their expectations have been subverted and their

time and space changed.

Facts have taught many western doctors who looked

down on Traditional Chinese Medicine and thought that

Traditional Chinese Medicine cannot solve any problems;

2020/02Ⅰ 51

Experiences of clinical masters｜名家心得

Cao Lirong, deputy chief physician of obstetrics and

gynaecology who performs surgery in Wuhan No. 1

Hospital, treated herself successfully by syndrome

differentiation knowledge of TCM. Doctor Zhan Tao,

who works for the Department of Neurology of Changsha

western medicine hospital, treated nearly 100 patients

with Traditional Chinese Medicine. The appearance of

these phenomena looks like sudden and accidental, but it

does show a certain inevitable trend, and indicates western

medicine doctors the necessity and great future value to

learn Traditional Chinese Medicine.

“ The Sinicization of Western Medicine“

and “ the Globalization of TCM” are coming

In the process of COVID-19, Traditional Chinese

Medicine plays a greater role than the SARS period,

which moved and educated a lot of western medicine

doctors, also changed some people’s understanding who

once discredited the Traditional Chinese Medicine.

Cao Lirong, deputy director of obstetrics and

gynaecology at Wuhan No. 1 Hospital, often performed

surgery and was infected COVID-19 when treating

patients. She applied TCM treatment to herself and cured

very soon. This is different from the method adopted

by western medical experts such as Li Wenliang, and

the results are also different. Zhan Tao, a physician

of Department of Neurology in the First Hospital of

Changsha, after studying Traditional Chinese Medicine,

treated 100 patients in the first line. He relied on

TCM syndrome differentiation rather than a specific

prescription.

The successful experience of these two “Western

Medicine studying TCM” reveals the necessity and

importance of Sinicization of western medicine.

At present, COVID-19 has spread all over the

world. Through this epidemic situation, we can also see

the necessity of Traditional Chinese Medicine going to

the world, that is, not only TCM acupuncture needs to

go globe wide, but also TCM herbs and other treatment

methods, as well as the whole Traditional Chinese

Medicine system, should go to the world for the benefit of

human being. Therefore, after the Sinicization of western

medicine, a process of globalization of Rraditional

Chinese Medicine will also follow.

Traditional Chinese Medicine plays very important

role in COVID-19’S treatment. However, it is definitely

not a top show of the Traditional Chinese Medicine. As

Zhang Xiaotong and other Chinese medicine colleagues

have said, Traditional Chinese Medicine is in a hurry to

respond to the battlefield with shackles after decades of

transformation and is ordered to fight in distress. It is only

a little show of TCM.

There is no doubt that this time, TCM practitioners

who have the opportunity to display their talents on the

front line are basically the personnel within the system. A

large number of folk TCM personnel with unique skills do

not have the chance to play a role on the first line. Some

of them feel frustrated and almost find no way to serve the

country.

However, when the Traditional Chinese Medicine

faced the outbreak of the epidemic, there was indeed

a lot of chaos and there were different opinions at the

same time. As to the causes of chaos, there are historical

reasons, but more importantly, the unsuitable teaching

materials are the main cause.

Under the background of coexistence of Traditional

Chinese and western medicine, COVID-19 can be cold

damage or warm disease, the difference between them

is only the type of syndrome and the treatment choice

of Xin Wen ( pungent warm ) and Xin Liang (pungent

cold). Rather than the difference between three infectious

diseases in western medicine, not the difference between

pneumonia and meningitis, virus and bacteria. Despite of

52 Ⅰ2020/02

临床名医｜Clinic Specialist

various infectious diseases in western medicine, febrile

disease, cold damage, warm disease and plague in TCM

are all studied on the common pathogenesis, transmission

characteristics, diagnosis and treatment.

The purpose of releasing exterior with pungent warm

herbs is to remove heat, not to dissipate the coldness;

the cold damage is a febrile disease, not a deficiency

cold disease; Zhang Zhongjing only indicated applying

sweating method and relieving the exterior, he never said

that hot nature herbs must be used. In Zhang Zhongjing’s

time, there was no rule for pungent cold herbs to release

the exterior, rather than that he opposed and did not adopt

the pungent cold solution.

The name of disease in TCM is rooted in the

theory of Traditional Chinese Medicine itself. Oracle

bone inscriptions can name COVID-19 as plague, that

is to say, it is epidemic; Nei Jing can name it as febrile

disease, because this kind of disease is characterized by

fever; Nan Jing, Zhang Zhongjing said it is cold damage,

and Cao Zhi of the same era said that is plague; Nei Jing

indicates applying sweating method within three days and

purgation method three days later. Hua Tuo added one

method as vomiting for four days later. Zhang Zhongjing

recommended eight methods and 397 methods, which

shows the treatment methods are more and more abundant.

However, Zhang Zhongjing was called the medical

sage by later generations, and his prescription was

respected as the Jing Fang (classical formula), which

became a closed system. Since then, no matter how good

the prescription is, they still cannot be involved in the

six meridians syndrome differentiation system. As a last

resort, the specialists of febrile disease in order to pass on

their own experience, had to find another way to create

another system: warm disease system.

But the textbook compilers lack of the knowledge

of academic history research, and do not take into account

the background of the coexistence of Traditional Chinese

and western medicine. They only follow the wrong views

of the scholars of febrile disease in Qing Dynasty, always

go along with the old without keeping pace with the times,

and even further magnify the defects of warm disease

experts’ theory, insist that cold damage and warm

disease are completely different from all aspects such as

cause, pathogenesis, transmission, diagnosis and treatment.

They consider cold damage and warm disease belong to

two incompatible major disciplines, which separate the

historical ties, resulting in a variety of confusion.

Disease-syndrome combined with hierarchical

diagnosis and treatment is the prominent

characteristic of TCM

No matter the six meridians syndrome differentiation

of Shang Han Lun, or Wei Qi Ying blood and Sanjiao

syndrome differentiation of Wen Bing (warm disease)

theory, they all describe the process of development and

change of exogenous febrile disease from the exterior

to the interior, from mild to severe. Wu Jutong’s three

energizers syndrome differentiation also reflects the

change process of exogenous febrile disease from shallow

to deep, from light to heavy.

As diagnosis and treatment of plague (infectious

diseases) in TCM way, we cannot only name the disease

simply based on the primary level like cold damage, warm

disease and plague. It must be refined gradually to more

layers, at least three or four levels, in order to carry out

effective treatment.

That is to say, when a TCM practitioner faces

COVID-19’s patient, who is diagnosed with cold

damage, the practitioner cannot prescribe herbal formula

directly. Because there are still 6 types of syndrome

as “secondary level of disease name” belong to the

cold damage: Taiyang syndrome, Yangming syndrome,

Shaoyang syndrome, Taiyin syndrome, Shaoyin syndrome

2020/02Ⅰ 53

and Jueyin syndrome.

Still, Taiyang and other 5 syndrome also have

2 types: Jing ( meridian ) syndrome and Fu ( organ )

syndrome, as the third level of disease name .

Again, the Taiyang Jing ( meridian ) syndrome still

can be divided into “exterior excess without sweating”

and “exterior deficiency with sweating”, which is

deemed as the fourth level of disease name.

If COVID-19 patient is diagnosed as warm disease,

all the process of diagnosis and treatment is same as the

cold damage above. It means before prescribing herbal

soup medicine, the“disease name” must be gradually

layered down. After knowing the primary level of disease

name as warm disease, we need to refine it further to find

the “the secondary level of disease name”: Wei level,

Qi level, Ying level, or blood level;

Or refine it into upper jiao level, middle jiao level

or lower jiao level which are also the secondary level of

disease name.

And also like treating the cold damage patient above,

we need to “name” the disease layer by layer, untill the

syndrome and prescription corresponding to each other,

which is finally counted as “reach the bottom”. Only

then, the herbal soup formula can be prescribed.

No matter how many new infectious diseases there

are, traditional Chinese medicine is everlasting. Sitting in

the distant future of history, waiting for western medicine

to find all kinds of mutated or non-mutated viruses one by

one, there is no need to ask whether it is avian flu or swine

flu, Ebola, or AIDS, SARS, COVID-19, and so on, all of

which are simplified once and for all. The greatest truths

are simplest. Because in the absence of Western medicine,

the diagnosis and treatment path of TCM has begun to

take shape, the only thing we need to do is to integrate

them.

“ innovate while inherit ”is the instruction by

General Secretary Xi, it is also the call of the times.

To go to the world, traditional Chinese Medicine

must show its specific charactor and attach equal

importance to Tao ( rule ) and skills. We cannot settle

for less to use the laboratory indicators to limit the TCM

development, even try to westernize of Traditional

Chinese Medicine, which must end up losing ourselves.

April 24th 2020,Revised

（Hebei Academy of Chinese Medical Sciences）

（上接第55页）

假如新冠肺炎患者被中医诊断为温病，其诊治

过程也和被诊断为伤寒这样，必须逐步向下分层，

才能开具汤药。在知道是温病这个“一级疾病”名

称之后，无法凭此开具汤药，还要进一划分是卫分

病、气分病、营分病、血分病的“第二级疾病”名

称。

或者，分上焦病、中焦病、下焦病的“第二级疾

病”名称。并且还要进一步像面对伤寒病患者那样，

一层一层分下去，到了证候与方剂（方证）相对应的

时候，才算“探底”了，这个时候才能开汤药。

不管有多少新发的传染病，中医都是“万变不离

其宗”，来自遥远的古代，却坐在未来深处，当西医

一个一个去发现各种变异的或者没有变异的病毒，中

医不用问它是禽流感还是猪流感，是埃博拉，还是艾

滋病、非典、新冠肺炎等等，统统“大道化简”，一

劳永逸。因为在没有西医的时候，中医的诊疗路径，

和理论已自成体系，可在关键时刻“厚积薄发”。

“守正创新”是习总书记给我们的指示，也是时

代的呼唤。

中医药走向世界，必须彰显个性，道术并重，而

不能用实验室的指标限制发展，不能舍本逐末，西化

中医，丢了自己。

（作者单位：河北省中医院科学院）

Experiences of clinical masters｜名家心得

54 Ⅰ2020/02

临床名医｜Clinic Specialist

曹东义：新冠瘟疫的反思

◎曹东义 译者/张枫戎 陈思蓉

这一次新冠瘟疫爆发之后，习总书记亲自部署、

亲自指挥，在正月初一（1月25日）的政治局会议决

定采用“中西医协作”的模式救治患者。中医药人员

很快进入主战场，克服了中医药储备不足、不被医患

人员理解等重重困难，中医药迅速发挥了巨大作用，

取得了有目共睹的成果。方舱医院，这个本应该“风

声鹤唳”“哀声一片”的地方，空气中却飘着中药

香，不断上演着医患共做八段锦的动人画面，连过去

的“中医黑”也获得中医药的救助，战胜新冠肺炎重

获健康。

中国的“中西医协作”救助模式，令世卫专家

感慨不已，他由衷地说假如自己不幸感染了，也希望

来中国治疗。我想，他绝对不是羡慕中国ICU的呼吸

机，而是喜欢方舱医院的氛围与效果。

中医药“首选必治”，成为前所未有的事实

在过去各种疾病的医学救治方案里，中医药的

治疗方法都是列在最后，作为“备选的治疗措施之

一”，是“补充”和“替补”的角色，从来没有《诊

疗指南》把中医药的作用提高到“首选、必治”的突

出地位。然而，这一次新冠肺炎的治疗不一样了，中

医药的“参与率”“使用率”，中成药与汤夜使用比

例，直接成为考察指标，甚至有“一票否决”的价

值，哪里的中医药救治率低，哪里的工作就被动，成

为众矢之的、万夫所指。2020年2月12日湖北省卫健

委公布的数据，中医药参与治疗只有30%，这样的结

果立即引发一片哗然，尽管那里云集了全国最精英的

西医专家。对于中医药热切期盼的形势，过去从未出

现，现在一下子成为救命的时尚和网络流行的显学。

而且，有些希望“科学实验”西药、进口药的专家，

在几万例患者集中出现的时候，竟然凑不齐“入组观

察的人数”，这是他们始料未及的事情，可以说颠覆

了他们的预想，换了一个时空。

“西医中国化与中医世界化”即将到来

新冠肺炎过程之中，中医药比非典时期发挥了更

大的作用，感动了或教育了很多西医，也让有些“中

医黑”改变对于中医的认识。

武汉市第一医院的妇产科副主任师曹丽蓉，经常

做手术，并且在救治患者的时候被感染，她身患新冠

肺炎之后，用中医药的方法很快治好了。这与李文亮

等西医专家所采取的方式方法不同，结果也不一样。

长沙市第一院神经内科的湛涛主治医师，他学习了中

医之后，在一线治疗一百例患者，依靠中医辨证论治

而不是某个具体方药。

这两位“西学中”的成功经验，揭示了“西医中

国化”的必要性，及其重要性。

目前，新冠肺炎在世界范围内传播，经历这次

疫情，也可以看出中医药走向世界的必要性，也就是

不仅中医针灸需要走向世界，中医的药物和其他治疗

方法，以及整个中医体系都应该走向世界，造福于人

类。因此，在“西医中国化”之后，一个“中医世界

化”的过程，也将随之而来。

中医药在这次新冠肺炎救治之中的作用，是非

常重要的，但是，这绝对不是中医药作用的“顶级展

示”，而是如张晓彤等中医药同道所说，中医是在被

改造几十年之后带着枷锁上战场，受命于危难之际，

仓促应战，略显身手而已。

2020/02Ⅰ 55

毫无疑问，这一次有机会在一线展示才能的中

医，基本上都属于体制内的中医，大量身怀绝技的民

间中医药人员，没有机会到前线去发挥作用，他们有

些人觉得“冯唐易老，李广难封”，几乎是“报国无

门”。

但是，中医界面对疫情爆发的时候，的确有很多

混乱，乱说纷纭，莫衷一是。这些混乱形成的原因，

有历史的因素，更重要的是学校教材“上梁不正”造

成的。

在中西医并存的背景下，新冠肺炎既可以是伤

寒，也可以是温病，它们的区别只有发病类型不一

样，治疗选择上的辛温与辛凉的主要区别，而不是西

医三类不同传染病病种之间的区别，不是肺炎与脑

炎、病毒与细菌的不同。热病、伤寒、温病、瘟疫，

研究的都是各种传染病的共同发病规律、传变特征与

诊治方法。

辛温解表的目的，是为了除热，而不是散寒；伤

寒是热病，而不是虚寒病；张仲景只说当发汗、当解

表，从来没有说必须用热药。张仲景的时代，没有辛

凉解表的法则，而不是他反对辛凉解表、不采用辛凉

解表。

中医的疾病名称，都根源于中医自身的理论来

命名。“甲骨文”可以说新冠肺炎是瘟疫，就是说它

具有流行性；《内经》能说它是热病，是因为这类疾

病都以发热为主要特征；《伤寒论》张仲景说它是伤

寒，同时代的曹植就说它是瘟疫；《内经》治疗，三

日之前用汗法，三日之后用泄法；华佗增加一法，四

日用吐法；张仲景八法、三百九十七法，治疗的方法

越来越丰富。

但是，张仲景被后人称为医圣，他的方子被尊为

“经方”，成了封闭的体系。此后，再有多少好的方

子，也进不了“六经辨证”的体系。不得已，温病学

家为了把自己的经验传承下去，就另辟蹊径，开创了

另个一个温病学体系。

但是，编教材的人，缺乏学术史研究知识，也

没有把中西医共存的时代背景考虑进去，只是顺着清

代温病学者的错误观点，“始终顺旧”，不能与时俱

进，并且“变本加厉”，进一步放大了温病学家的不

足，硬说伤寒与温病在病因、病机、传变、诊治方面

“完全不同”，属于寒温、水火不容的两大学科，人

为割裂了历史的联系，造成了各种混乱。

病证结合分级诊疗，是中医突出的特色优势

伤寒的六经辨证，温病学说的卫气营血、三焦辨

证，都描述了外感热病由表入里，由轻而重的发展、

变化过程。吴鞠通所说的“三焦辨证”，也反应了外

感热病由浅入深，从轻到重的变化过程。

中医诊疗瘟疫（传染病）的疾病名称，不能简单

停留在伤寒、温病、瘟疫的“初级阶段”，必须逐渐

分层，到三四级之下，才能开展有效治疗。

也就是说，当一个中医面对新冠肺炎患者，他

（她）被诊断为“伤寒病”的时候，不能凭此诊断开

具汤药。因为，伤寒病下边，还有太阳病、阳明病、

少阳病、太阴病、少阴病、厥阴病的“第二级疾病名

称”。

太阳病等“病名”下边，还有“经病（证）”和

“腑病（证）”的“第三级疾病名称”。

太阳经病（证）下边，还有“表实无汗”病

（证）与“表虚有汗”病（证）的第四级疾病名称。

（下转第53页）

Experiences of clinical masters｜名家心得

56 Ⅰ2020/02

临床名医｜Clinic Specialist

与肿瘤博弈的策略与智慧

◎王振华

在科学高度发达的今天，肿瘤依然是高悬在人

们头上的一把利剑，一个人无论平时多么冷静自信，

多么勇敢坚强，一旦患了肿瘤，同样会惊慌失措，方

寸大乱。肿瘤不但考验医生，更考验患者及其家属，

因为相对其他疾病而言，肿瘤治疗方法的选择、决策

需要患者及其家属更多地参与其中。然而肿瘤治疗是

一个非常复杂的问题，既有西医的手术、放疗、化疗

等，又有中医中药，面对纷乱复杂的治疗方法，如何

选择和取舍对预后和转归至关重要，这不仅需要一定

的知识储备，更需要超越具体知识之上的综合能力、

思辨能力、决策能力，只有这样，才能在与肿瘤的博

弈中处变不惊，游刃有余，策略而又智慧地选择最佳

的治疗方法、方案，避免陷入误区，取得最后的胜

利。

1 什么是肿瘤？

西医认为，肿瘤是人体自身细胞的异常增生。所

谓异常增生，一方面是指增生得太快，超出了正常的

生长节奏，另一方面则是指肿瘤细胞与正常细胞的结

构不同。癌细胞的无限制增生足以摧残机体，置人于

死地，而这正是癌症的可怕之处。

从分子生物学层面看，肿瘤是机体在各种致瘤因

素作用下，细胞在基因水平失去了对其生长的正常调

控，导致异常增生而形成的新生物。也就是说，肿瘤

的本质是基因突变。

肿瘤有良性与恶性之分，良性肿瘤对机体的影响

不大，而恶性肿瘤则会导致严重后果。通常人们习惯

将恶性肿瘤称之为“癌症”，但严格地讲，癌症是指

起源于上皮组织的一类恶性肿瘤，如肝癌、乳腺癌、

皮肤癌等，占恶性肿瘤的80%～90%，而另外约10%

起源于间叶组织（包括纤维结缔组织、脂肪、肌肉、

脉管、骨和软骨组织等）的恶性肿瘤则称为肉瘤。

既然肿瘤是基因突变的结果，那么肿瘤与机体之

间的关系就是敌我矛盾，治疗目标就是杀灭癌细胞。

以杀灭癌细胞为目标是西医治疗肿瘤的主要方法，手

术、放疗、化疗是其经典方法，而新近发明的靶向治

疗、免疫治疗、基因治疗等，从根本上说，依然是杀

灭癌细胞，只是更为精巧、精准而已。以杀灭癌细胞

为目标是一种对抗性治疗模式，作为一种系统的治疗

肿瘤的方法和模式经历了漫长的历程，取得了伟大成

就，在肿瘤治疗中的地位和价值是毋庸置疑的，然而

对抗性治疗是一把双刃剑，效果虽然很明显，缺陷和

局限性也很明显。

2 对抗性治疗模式的缺陷和局限性

西医对抗性治疗模式的缺陷和局限性主要表现为

以下几个方面：

（1）治疗作用有限

以手术为例，肿瘤早期，由于病灶比较局限，手

术切除效果较好。然而临床上多数患者一经发现往往

已经是中晚期了，无法彻底手术切除，只能做姑息性

手术（部分切除肿瘤），此时，手术的作用是非常有

限的。其他局部治疗方法如介入治疗、放射治疗、射

频消融、激光、氩氦刀等也存在类似问题。

（2）促进肿瘤转移

据报道，所有以消灭肿瘤细胞为目标的治疗方

法，包括姑息性手术、介入治疗、放疗、射频消融、

化疗，甚至靶向治疗等，均可导致未被杀灭的残存癌

2020/02Ⅰ 57

细胞转移潜能增强，而且发现，这些肿瘤转移潜能的

提高还伴有不同的基因改变。这就提示，对抗性治疗

模式激发了肿瘤细胞的耐受、进化和逃逸机制，而这

已经成为肿瘤治疗失败的主要原因。

（3）毒副作用比较严重

以化疗为例，首先化疗药物往往敌我不分，在

杀灭肿瘤细胞的同时，也会杀灭正常的组织细胞，所

谓“杀敌一千，自损八百”，其对机体的摧残是巨大

的；其次，化疗药物通常具有明显的胃肠道反应，骨

髓抑制以及肝肾功能损害等。很多患者往往因无法耐

受化疗药物的毒副作用而被迫终止治疗，甚至有些患

者因化疗药物的毒副作用而加速死亡。

（4）对肿瘤的复发与转移乏术

以直接杀死肿瘤细胞为目的的对抗性治疗方法，

并没有从根本上触及肿瘤得以产生的原因和土壤，治

标不治本，因此，对于肿瘤的复发与转移基本上束手

无策，而复发与转移恰恰是决定肿瘤预后的关键。

3 中医对肿瘤的认识

中医对肿瘤的命名包括“瘤”“积聚”“癌”

等。“瘤”者，留也，有停留、阻塞、聚集之意，故

中医又称肿瘤为“积聚”。大家熟悉的“癌症”之

“癌”字其实就来自中医，宋代医家杨士瀛在《仁斋

直指附遗方论》中记载：“癌者上高下深，岩穴之

状……毒根深藏，穿孔透里”。可见，“癌”是古人

对肿瘤形状的描述。

在中医看来，肿瘤的发生是由于气滞、血瘀、

痰阻等导致经络不通，气血运行不畅而形成的一类疾

病。具体内容包括：（1）气滞、血瘀、痰阻等导致

经络不通。（2）经络不通，则局部组织得不到正常

气血阴阳的温润和滋养而发生变异，形成对机体有害

的恶肉、毒瘤，其状峻险，如癌如岩。（3）从经络

阻滞不通到形成肿瘤经历了漫长的过程，肿瘤相对

独立，在机体局部“安营扎寨”，形成“巢穴”。

（4）肿瘤对机体的危害性在于对机体组织结构的浸

润破坏，并以其特有的方式盗取机体的营养，最终导

致机体衰竭而死亡。（5）肿瘤并非外来物，并不完

全是异己分子（比如细菌、寄生虫、脓肿等），虽然

不完全受机体节制，但毕竟与正常组织同源、相似，

与机体共生共存，息息相关。

不难发现，肿瘤与机体的关系非常像匪寇与政

府的关系。由良民落草为寇的原因无非有二，一是物

质匮乏，二是精神扭曲，两者都可以理解为个体因得

不到政府的阳光雨露，误入歧途，落草为寇，危害一

方，成为社会的毒瘤。对于匪寇该如何处置呢？方法

无非有两种，一是剿灭，二是招安。也就是说，除了

剿灭，如果晓之以理，动之以情，并给其以出路，匪

寇是可以弃恶从善，改邪归正的。肿瘤也是如此，除

了剿灭，也可以安抚，即让癌细胞改邪归正。

明代医家李中梓在《医宗必读·积聚》中指出：

“初者，病邪初起，正气尚强，邪气尚浅，则任受

攻；中者，受病渐久，邪气较深，正气较弱，任受且

攻且补；末者，病魔经久，邪气侵凌，正气消残，则

任受补。”这里的“攻”就相当于剿灭，而“补”则

相当于安抚。

扶正祛邪是中医治疗肿瘤的基本方针，具体地

说，祛邪的方法有：以毒攻毒法，软坚散结法，行气

解郁法，活血化瘀法，化痰散结法，清热解毒法等；

而扶正的方法有：补气养血法，滋补肝肾法，健脾益

肾法等。

可见，在中医眼里，肿瘤与机体之间并非简单的

敌我矛盾，而是息息相通，休戚与共，是一个无法截

然分割的有机整体。在治疗上并非简单地剿灭，而是

立足整体，审时度势，攻补结合，恩威并施，与冷冰

冰的手术、放疗、化疗等相比，多了一些温度、多了

一些智慧，也多了一些希望和出路。

古人云：“善弈者谋势，不善弈者谋子，善谋

势者必成大事。”西医擅长“谋子”，而中医则擅长

“谋势”，虽然从杀灭癌细胞的角度看，西医的优势

非常明显，但从长远看，中医审时度势，攻补结合，

进退有方的治疗模式更为深邃、睿智。中药取之于自

然，没有明显的毒副作用，只要假以时日，便可水滴

石穿，峰回路转，收到意想不到的神奇效果。

Experiences of clinical masters｜名家心得

58 Ⅰ2020/02

临床名医｜Clinic Specialist

基于对剿灭模式缺陷和局限性的反思，西医对肿

瘤的认识也在改变。动物实验证明，将肿瘤细胞移植

到正常成年动物体内并不产生肿瘤，而且还参与正常

器官的构成；对肿瘤细胞的细胞外基质加以干预，可

诱导癌细胞转化为正常细胞。临床报道，三氧化二砷

对某一类型的白血病有效，而其作用并非直接杀死白

血病细胞，而是使其“改邪归正”。反式维A酸也有

类似作用，这种治疗叫作“分化诱导治疗”。

西医这一新的发现与中医对肿瘤的认识不谋而

合。也就是说，西医也逐渐认识到肿瘤是一种全身性

疾病，同时也是一种慢性病，无法速战速决，必须

打持久战，否则欲速则不达，反而加速患者的死亡。

“带瘤生存”“打持久战”等策略的提出，目的就在

于为剿灭模式降温，防止过度治疗带来的危害，强调

综合效果，强调患者的生存时间和生活质量。西医中

有远见卓识者再次将目光投向中医中药。

4 中西医结合治疗肿瘤的策略

对于肿瘤，西医长于剿灭，速战速决；中医长于

调理，打持久战。因此，临床上一般西医打头阵，先

有效地清除、剿灭肿瘤，然后由中医来收拾残局。中

医与西医相互结合，取长补短，可以收到更为理想的

效果。

（1）中医中药配合手术

手术切除是治疗大多数实体恶性肿瘤行之的有效

方法，尤其是对于早期肿瘤，手术切除可以获得较好

的效果，部分患者可长期缓解甚至治愈，故又称“根

治性手术”。为了防止复发，追求“根治”效果，曾

经有片面扩大手术范围的倾向，然而真正达到“根

治”效果的毕竟是少数，多数患者会复发，过度的手

术创伤反而加速患者的死亡。相反，适当缩小手术范

围，患者的生存时间反而更长。恶性肿瘤的手术治疗

经历了“由小到大、由大到小、保全功能”的再认识

过程。对于中晚期肿瘤，手术的意义只是减轻肿瘤负

荷，称之为姑息性手术。因此，无论是早期、中期还

是晚期，手术之后并非万事大吉，而是要治病求本，

防止肿瘤的复发与转移。

手术具有明显的创伤性，术后患者往往身体虚

弱，体质下降，对此，中医的调理脾胃，补气养血等

治疗方法，可以改善体质，促进术后康复。手术康复

之后，采取中医辨证施治，可以从根本上纠正肿瘤得

以产生的土壤，防止肿瘤的复发和转移。

（2）中医中药配合化疗

与手术类似，也有“根治性化疗”之说，所谓根

治性化疗，是指某些肿瘤对于化疗药物敏感，通过系

统、充分的化疗可以收到长期缓解甚至治愈的效果。

这些肿瘤细胞增殖快，与正常细胞的分裂周期有一个

明显的时间差，因而对化疗药物比较敏感，容易被化

疗彻底摧毁。主要包括：恶性淋巴瘤、急性白血病、

睾丸精原细胞瘤、绒癌等。

除了根治性化疗，尚有辅助化疗和姑息性化疗。

所谓辅助化疗是指配合手术、放疗而进行的化疗，旨

在提高手术、放疗的治愈率。对于手术后复发、转移

或无法手术切除者，化疗的目的在于使肿瘤缩小，减

轻症状，延长生存时间，称之为“姑息性化疗”。

无论是根治性化疗、辅助化疗，还是姑息性化

疗，共同的问题是毒副反应比较严重，因此，化疗必

须审慎、适度，过度化疗会适得其反，加速患者的

死亡。尤其是对于姑息性化疗，治疗作用有限，却要

承受化疗药物严重的毒副作用，如果患者体质可以耐

2020/02Ⅰ 59

受，则给予适度化疗，否则，应选择中医中药治疗。

化疗药物常见的毒副作用包括胃肠道反应、骨髓

抑制、肝毒性、肾毒性、心脏毒性等，在化疗期间配

合中药，可以明显减轻化疗药物的毒副反应，增强人

体对化疗药物的耐受性以及敏感性（减毒增敏），顺

利地渡过化疗难关。

（3）中医中药配合靶向治疗

所谓靶向治疗是指在方子水平找出精确的致癌

靶点（该靶点可以是肿瘤细胞内部的一个蛋白分子或

者基因片段），进而设计相应的药物阻断这些靶点，

达到杀死肿瘤细胞的目的。由于这些致癌的靶点往往

为肿瘤细胞特有或者在肿瘤细胞中含量更为丰富，因

此，靶向治疗对肿瘤细胞的特异性较传统化疗更强，

而副作用相对较小。目前，靶向治疗较为成功的肿瘤

主要有乳腺癌、胃癌、小细胞肺癌、B细胞淋巴瘤、

胃肠道间质瘤、黑色素瘤、结直肠癌、卵巢癌等。

靶向治疗将西医对肿瘤的治疗推向了一个新的高

度，为肿瘤患者带来了更多希望。然而，依然有其局

限性，表现为：其一，靶点寻找困难，目前只有为数

不多的肿瘤找到了靶点；其二，找到了靶点，未必找

到了药物；其三，即使找到了药物，也不是所有人都

有效，对于同一种肿瘤，有的人有靶点的表达，有的

人没有表达。例如，曲妥珠单抗只对约25%～30%的

乳腺癌患者有效。其四，靶向治疗也有副作用，有的

靶点并非完全为肿瘤细胞所特有，正常细胞也有不同

程度的表达，从而引起各种各样的不良反应。多靶点

药物则可引起广泛而严重的副作用。另外靶向药物也

具有通常意义上的胃肠道反应、骨髓抑制以及肝肾功

能损害等不良反应。更为重要的是，从根本上说，靶

向治疗的性质依然属于剿灭模式，只是更为精巧、精

准而已，所以靶向治疗也需要与中医中药相结合，方

可收到更为理想的效果。

（4）中医中药配合放射治疗

放射治疗对早期霍奇金淋巴瘤、睾丸精原细胞

瘤、肾母细胞瘤、神经母细胞瘤、视网膜母细胞瘤等

比较敏感，其次对鼻咽癌、口腔癌、皮肤癌、宫颈

癌、食管癌等效果也可以。放射治疗的副作用有皮肤

黏膜损伤、厌食、恶心、呕吐、发热、血细胞降低

等，配合中药常常可以使其减轻。

此外，西医尚有介入治疗、免疫治疗、内分泌治

疗等，均有其相应的适应证，在临床上常常与手术、

放疗、化疗等相结合，在此不再一一赘述。

临床上经常遇到一些肿瘤晚期的患者，肿瘤已

经扩散转移，既失去了手术机会，又对放、化疗不敏

感，或者因年高体弱无法耐受放疗、化疗，此时，中

医中药成了他们唯一的救命稻草。通过服用中药，大

部分患者症状减轻，生活质量改善，生存时间延长，

肿瘤生长减缓、缩小甚至消失。

5 结语

如果问，什么疾病最可怕？肿瘤一定排会在第

一。可以说，没有哪一种疾病像肿瘤一样让人突然变

得惶恐和脆弱；也没有哪一种疾病像肿瘤一样能够

让人放下一切，像投入战斗一样严阵以待；更没有哪

一种疾病像肿瘤一样让人重新审视自我，重新规划人

生。与肿瘤博弈不仅仅需要知识，更需要策略与智

慧，这种策略和智慧不仅可以帮助人们走出肿瘤的阴

影，同时也会让人们重拾自信，以全新的姿态面对人

生。

（作者单位：中国人民解放军总医院第八医学

中心）

作者简介：王振华，医学博士、博士后，毕业

于中国中医科学院研究生院，先后在西苑医院攻读

心血管专业博士学位，在广安门医院作肿瘤专业博

士后研究。原就职于解放军总医院第八医学中心。

从事中医临床30余年，以“弘扬中医，济世惠民”

为己任，勤求古训，融汇新知，躬身实践，勇于创

新，对多种慢性疑难病症的诊治得心应手，疗效显

著。行医感言：心系苍生方开慧，艺经百炼可通

神。

Experiences of clinical masters｜名家心得

60 Ⅰ2020/02

临床名医｜Clinic Specialist

Unknown cause treatment equals neither

prevent nor reduce the deterioration of the

health of an individual

◎Li Shan Ju

1.Teacher You Xiyin is one of a few pure Chinese

medicine doctors in this era. He pays no attention to

fame and fortune. He has a noble medical ethics, superb

medical skills, and is humble in the public.He is a

traditional Chinese medicine doctor, but he doesn't stick to

stereotypes.He integrates the benevolence of doctors into

clinical practice, and he combines modern technology with

traditional Chinese medicine.Without the support of any

capital, he clinically overcome the difficulties of leukemia

treatment and obtained the corresponding national patent.

But teacher You XiYin is little known.The reason why our

cover character introduced him is because he is a powerful

faction who speaks with "efficacy", and he is also an

advocate and practitioner of clinical symptoms and cause

treatment.

2.Leukemia is commonly known as blood cancer,

especially in children and adolescents with a high mortality

rate.Traditional Chinese medicine, as a traditional treasure

of China, has a long history and profound knowledge. It

has good effect, fast recovery, low cost, and low toxicity

and side effects in the treatment of blood diseases. It

has been widely concerned by scholars at home and

abroad. On the patent website of the State Intellectual

Property Office of the People's Republic of China, the

patent number ZL2007101193834 "A traditional Chinese

medicine composition for the treatment of leukemia and

its preparation method" is impressive, the patent inventor

is You XiYin.Who is You Xiyin? What kind of academic

attainments made his research achievements in the

treatment of hematological diseases of Chinese medicines

win national patents?

3.You Xiyin was born in 1951 in a village in the

hometown of Qihuang in Qingyang, Gansu Province.

Qingyang is the beginning of the "QihuangzhiShu” of

the Chinese people and the source of the Chinese farming

culture.Traditional Chinese medicine has always occupied

a dominant position in the field of this area, and it is very

popular among local people. Famous Chinese medicine

doctors were from various local families.You Xiyin is

the third generation of TCM descendants of the You

family in Changle Prefecture, Longyuan, Gansu Province.

Since his childhood, XiYin has been reading classics of

traditional Chinese medicine under the guidance of his

grandfather, and has learned to recognize herb medicine,

process the herb medicine and use the herb medicine.

The You family has a high reputation and prestige in

Qingyang, and it is deeply supported and respected by

the local villagers.You Xiyin, who has been in the past

few years, can still remember the classics of traditional

Chinese medicine when he was young. We often hear

people say that someone has TCM merit, which refers to

people like XiYin.In his youth, You Xiyin worked as a

barefoot doctor for a few years, but after the outbreak of

the Cultural Revolution, he stopped practicing medicine

and decided to go to an engineering design school and

become an engineering designer.During the Cultural

2020/02Ⅰ 61

Revolution, Chinese medicine was considered to be one

of the four legacy left by feudal society. A large family

of Chinese medicine such as You Xi Yin has suffered a

violent impact. All the medical books in his family were

piled up in the yard for incineration. Due to the large

number of ancient medical books, the smoke from the

burning books did not disappear for days and nights.His

father was also taken away to fight in the street wearing

a sign. During the parade, a villager secretly replaced

the brand worn by his father with a fake paper sticker,

which looked large but light in weight. The simple folks,

in this way, return this folk good doctor. Shortly after Xi

Yin’s father was forced to list and travel the street, the

red guards demolished the door of his home as a feudal

superstition, and the family cultural heritage of several

generations was immediately destroyed, and his father

was lying in chaos. Throwing on the ground at the gate

beam of the gate, weeping helplessly like a child. Due to

excessive sadness, he died of anger in a few days. The

death of his father was greatly affected by Xi Yin, and

he decided not to practice medicine. Go far away and

study engineering design. In the field of engineering

design, Xi Yin quickly grew into a senior engineer with a

good income and a very comfortable life. But he always

felt that his life was missing something. After the end

of the Cultural Revolution, all people in the society are

getting better every day, and new social diseases are also

getting more and more every day. Depression has become

a new stubborn disease that destroys healthy lives. A

prestigious distant relative of the You family, best at doing

communication work for others, for some reason, suffering

from severe depression, after a period of self-torture,

he eventually ended his life by suicide.When the news

reached Yu Yin's ears, he was shocked. The laughter of

the distant relatives in the past and the scene of solving the

problems for the folks are still vivid.Moreover, depression

is not a terminal illness! The death of this relative is like

Cover clinical specialists｜ 封面名医

opening the door to bad news, one after another, and some

news of serious illness or death.The medical consciousness

rooted in the heart and immersed in the bone marrow from

a young age makes You XiYin think that these people

can obviously save lives! At this time, another bad news

came that a child of a family member of the family had

leukemia and was lying on the bed.From the last period

of the child's life in the hospital bed, You XiYin clearly

found that the child's leukemia symptoms were very

similar to the anemia that was treated by the grandfather.

Recalling the process of the grandfather's treatment

and the memorized medical books, and the father had

enlightened him to treat the medical treatment of anemia,

he suddenly realized the treatment. He deplored the death

of the child.The Qi Huang spirit that flows through the

blood of the clan's family and rescues the crisis, reminds

of Yu Xiyin all the time: Is it going to be a doctor again

in the future life?When he was working in Xi'an, a

seriously ill young girl with leukemia found Yu Xiyin on

the recommendation of a friend. The patient knew that

the Chinese medicine of his family from generation to

generation had a high reputation, and the patient begged

Yuxi to treat her leukemia. You Xi Yin described a

prescription for her and asked her to grab three pieces

of herbal medicine. Try it. If it works, then take it. If it

doesn’t work, go to another doctor.Later, there was no

news of young women. A few years later, when a middleaged woman kneeled and thanked him with two children,

he learned that this person was a leukemia patient who he

had inadvertently cured a few years ago.The news that Xi

Yin could treat leukemia spread like wildfire. The sense

of responsibility and mission of treating and saving people

made him decisively give up his professional design and

start to take the road of medical treatment again.You Xiyin

said: "While modern medicine has given a high name to

many modern diseases, it is daunting, but as long as you

know the cause, find the root cause, apply the right herbal

62 Ⅰ2020/02

临床名医｜Clinic Specialist

medicine, and the treatment will have wonders. When I

was a child, I often heard my grandfather say to his father:

Treatment without knowing the cause is murder!" This

sentence was also regarded as the highest criterion for

practicing Chinese herbal medicine.Xi Yin began research

on blood diseases in 1981, and made breakthrough

progress in the research of traditional Chinese medicine

treatment of blood system diseases. He obtained a national

patent for the treatment of leukemia in 2007. He settled in

Tongzhou, Beijing in 2008 and concentrated on Chinese

medicine for blood diseases. According to You XiYin, the

effect is the objective standard of Chinese medicine. The

real effect of traditional Chinese medicine is both to treat

the symptoms and treat the root or cause of diseases.

4.The old Yuxi has the spirit of a middle-aged

man in his forties. His eyes were bright and sharp, his

words were powerful, and he was full of integrity.He

said: Acute leukemia belongs to the categories of "warm

poison", "heat labor" and "blood syndrome" of Chinese

medicine. Chronic leukemia belongs to the categories of

"deficiency", "disease", "disease", and "sputum nucleus"

of traditional Chinese medicine based on its manifestations

of weak anemia, enlarged liver and spleen, and lymph

nodes.At present, some scholars have summarized the

etiology and pathogenesis of leukemia into three points:

one is due to evil excess cause the diseases, and chronic

illness causes deficiency; the second is due to deficiency

and illness, and then becomes a futile labor;The third is

the combination of deficiency and evil excess. Through

research and analysis of leukemia, it is believed that in

addition to internal and external factors in traditional

Chinese medicine theory, junk food, environmental

pollution, the abuse of hormones and antibiotics, ionizing

radiation and other chemical and physical factors can

cause spleen qi deficiency and bone marrow. In the early

1960s, some scholars divided leukemia into 6 syndrome

types: Yin deficiency type, Yang deficiency type, Yin

and Yang deficiency type, fatigue type, phlegm-heat

type and warm type.From Xiyin, leukemia is divided into

three categories: one is poisoned into the bone marrow,

the patient has high fever, sweating and heat, hemorrhage,

anemia, hepatosplenomegaly, lymphadenopathy,

dizziness, bone pain, joint pain, pulse like flood Big.This

type is more common in adolescent patients, manifested

as various acute leukemias or various chronic leukemias

during the acute attack period, the onset is rapid and fierce.

The second is liver and kidney disease and stasis and

poisoning, patients with hot flashes and night sweats, five

upset fevers, frequent irritations, general weakness, weight

loss, hepatosplenomegaly, especially spleen, sternal

tenderness or pain in the ribs, pulses wiry tread rapid

or thread rapid. This type is more common in chronic

myelogenous leukemia.The third is spleen and kidney

deficiency and stasis and toxin. The onset is slower than

the first two, pale, dizziness, palpitations, waist and knee

soreness, fatigue, poor appetite, enlarged liver and spleen

or lymph nodes, pale tongue and less fur, pulse pulse

fine. This type is more common in patients with chronic

lymphocytic leukemia.What is the cause of leukemia,

it is necessary to use the corresponding symptomatic

Chinese medicine, so that the effect is significant.Chinese

medicine is not slow, symptomatic Chinese medicine can

take effect after taking 3 to 5 package of Chinese herbal

formula. If the effect of the herbal medicine is slow to

one or two months, the patient will not be alive.According

to Xi Yin, the treatment of leukemia with traditional

Chinese medicine cannot be measured by the relevant

indicators of Western medicine. The patient's morbidity in

the morbidity of the cells has been constantly changing in

uncertain factors. Pursuing the ever-changing indicators

inevitably will delay the current emergency condition.

The key is to See if the patient's Jingqi has improved in

time after taking the medicine. If you are full of spirit and

energy, all related physiological indicators will naturally

2020/02Ⅰ 63

improve, that is, righteousness and evil are not necessary.

According to Xi Yin, the human body has the integrity

and systemic nature of the unity of nature and man. For

any disease, the blindness of local confrontation without

the integrity and system conception will definitely lose the

true intention of medicine.Traditional Chinese medicine

pays attention to balance and harmony. The disease of the

human body stems from the original balance of the system

being broken. Therefore, the Yellow Emperor's Internal

Classic believes that the disease is "born in yin or yang."

In the study of leukemia, analyze the mechanism of the

disease, diagnose and explore the pathology in various

ways, that is, "differentiation".The diagnosis of TCM is to

"look, smell, ask, and touch” to understand the condition

of the disease, identify the attributes of surface, cold, heat,

virtual, yin and yang, and then determine the treatment

according to the pathological changes such as etiology,

viscera disease position, qi, blood and fluid. Methods,

using the corresponding Chinese medicine herbs.

5.Clinical practice works like a god, meditation

is the secret.You Xiyin has decades of peace-keeping

practice, he believes that all diseases are born from

emotional stress (heart).Although the etiology of the

patient is very complicated, the heart is the master.To

date, none of the leukemia patients he has treated have

been caused by the same etiology. In order to find out

the exact cause, the doctor must practice meditation to

improve his understanding and correctly judge the related

pain mechanism.Chinese medicine professionals with

meditation skills have the wisdom to find out the cause.

If a Chinese medicine practitioner does not meditate

internally, even if he is very smart, it is nothing but clever.

Modern Chinese medicine practitioners have a lot of

stress in life and have a lot of daily chores. There are few

people who have a pure and calm heart. This pure heart

cannot fall from the sky, it can only be obtained through

meditation. Meditation can make people concentrate,

not distracted. The specific method of meditation is to

meditate, adjust your breathing, and carefully observe your

own mental state, from static to fixed, from which you can

get physical and mental purity, and open wisdom. Wisdom

(Hui) comes from Zen.During the process of meditation,

self-adjustment of body, self-adjustment of breath and

mind. The interest-adjustment can purify one's physiology

and psychology, and one's life will be relaxed and

vigorous. The wisdom gained through meditation can help

people eliminate greed, aversion, infatuation, slowness,

doubt and other troubles. The wisdom brought by deep

meditation can eliminate these troubles, bring life into

truth and tranquility, reconnect the body and the soul, and

in the softness and lightness, make one's life a pure and

beautiful magic power. As a Chinese medicine practitioner

who has been meditating, his heart and wisdom is like

a mirror, and he has insight into the patient's condition.

In the process of deep exploration of leukemia by You

Xi Yin, it is precisely meditation that allows him to be

loyal to objective facts in clinical practice. As a result, his

prescribination of herbal medicine has the help of divine

aid and has a significant effect. Regarding meditation,

You Xiyin once published a monograph entitled "Dao

Dao Health Preservation", which is regarded as a rare

traditional authentic health practice by the society.

6.Meeting new healthcare challenge needs, Chinese

medicine is a miracle.Chinese medicine is a general

practice, and leukemia is just one of the modern diseases

that You XiYin is good at treating. There are too many

patients looking for him to treat leukemia, and most of

these patients are ruined and penniless.Faced with many

troubled leukemia patients, Yu Yin often feels unable to

help. He hopes that the patents for his leukemia Chinese

medicine composition and its preparation method can

be transformed as soon as possible to benefit more

patients. This is the crystallization of the practice of

medicine by several generations of the family, and it is

Cover clinical specialists｜ 封面名医

64 Ⅰ2020/02

临床名医｜Clinic Specialist

also the crystallization of traditional Chinese medicine

and modern technology.He said: "The emphasis is on

syndrome differentiation. Traditional Chinese medicine

should be innovative in order to show its vitality in the

new era. The principle of innovation is to meet the health

needs of the people in the new era." Xi Yin pointed

out In order to meet the health needs of the people,

traditional Chinese medicine needs to innovate on the

basis of the original without breaking away from the

traditional medical track.Traditional Chinese medicines

are usually prepared by roughing and extracting essences,

such as quenching, braising, calcining, frying, and so on

processing . Innovative invention is to study its theory

and pharmaceutical technology in a broad sense, and

to innovate the traditional Chinese medicine service

method, usage, manufacturing technology, processing

accessories, and process flow to adapt and meet the needs

of modern people to the greatest extent.Safety and high

quality are the two aspects most valued by Xiyin. He

said that the key to controlling the quality of herbs lies

in the quality of medicinal materials and the technical

standards of the extraction process. Traditional Chinese

medicine prescriptions are based on standard decoctions,

and they attach great importance to the compound effect

of prescriptions and single-flavor Chinese medicines.

They often control the internal quality of raw materials

in many aspects.The invention by Xiyin not only focuses

on the process of selecting, extracting, concentrating, and

drying medicinal materials, but also avoids the loss and

destruction of the index components of the main herbs.

He strictly controls the stability of the product to ensure

the high quality of the product after molding. Because

the invention inherits the comprehensive curative effect

of decoction, it is easy to absorb, has obvious effects,

and has the advantages of ready-made medicine, easy

storage, easy to carry, and easy to take. The declaration

is very smooth.According to Xi Yin, there are serious

problems in the production, study, and research of Chinese

medicine in my country. Few companies are willing

to invest in this aspect, making innovation in Chinese

medicine "important in speaking and secondary in doing

it." He believes that the examination of the innovation

effect of traditional Chinese medicine takes a lot of

manpower and material resources. If Western medicine

indicators are used to verify and explain the theory of

traditional Chinese medicine, this is inappropriate. The

affirmation and utilization of traditional Chinese medicine

should be shifted from "emphasis on experiment and

light on clinical" to "emphasis on clinical and light on

experiment", that is, avoiding short-selling theory and

speaking with actual effect is the essence of medicine.

The so-called innovation of traditional Chinese medicine

must be fully understood Chinese medicine innovates on

the basis of its own enlightenment. Otherwise, using only

a little level of limited knowledge to innovate traditional

Chinese medicine with profound cultural heritage will

become a perpetual sinner who destroys the image of

traditional Chinese medicine.Xiyin hopes that relevant

national functional departments can use Chinese medicine

patents to promote the progress of Chinese medicine

technology, enhance the competitiveness of Chinese

medicine in domestic and foreign markets, combine

Chinese medicine technology research and patents, study

international patent regulations and declarations, and

organize professional technical personnel and experts

To jointly discuss and formulate protective measures to

promote the development of traditional Chinese medicine

to the mainstream international pharmaceutical market.

The author sincerely hopes that the patent of "Chinese

medicinal composition for the treatment of leukemia and

its preparation method" invented by Xi Yin will be able to

give healthy help to leukemia patients in the society with

the support of investors.

2020/02Ⅰ 65

由玺印：不知病因的治疗等于杀人

◎李善举

白血病俗称血癌，特别是儿童、青少年发病率较

高。中医药作为中华民族的传统瑰宝，历史悠久，博

大精深，在血液病的治疗方面具有疗效好、速度快、

费用低、毒副作用小的优势，受到国内外学者的广泛

关注。中华人民共和国国家知识产权局的专利网站

上，“一种用于治疗白血病的中药组合物及其制备方

法”（专利号ZL2007101193834）赫然在目，专利发

明人是由玺印。

由玺印是谁？是什么样的学术造诣，让他的中药

治疗血液病研究成果荣获国家专利？

济危救困日月鉴，难舍中医动乾坤

由玺印，1951年出生于甘肃省庆阳地区歧黄故

里的一个村庄里，庆阳是华夏民族“岐黄之术”的开

端，华夏农耕文化的源头。中医在这个地区的医疗领

域里一直占据着主导地位，深受当地百姓的欢迎。当

地各个家族的名中医也人才辈出。由玺印是甘肃省陇

源地区长乐府由氏家族第三代中医传人。由玺印自幼

年开始，就在祖父指导下熟读中医经典，并学习识

由玺印老师是当今这个时代为数不多的纯正中医人之一。他不计名利，医德高尚，医术精湛，

深藏民间。他是传统中医人，却不墨守陈规。他把医者仁心融入临床实践，他让现代科技与传统中医

完美结合。他在没有任何资本的支持下，在临床上攻克白血病治疗难关，取得了相应的国家专利。但

是由玺印老师却鲜为人知。我们的封面人物之所以推出他，是因为：他是用“疗效”说话的实力派，

他还是临床标本兼治的倡导者和践行者。

编者按

Cover clinical specialists｜ 封面名医

66 Ⅰ2020/02

临床名医｜Clinic Specialist

药、制药和用药。由氏家族在庆阳当地的名声和威望

很高，深受当地村民的拥戴和尊崇。现今已经近古稀

之年的由玺印对年轻时读过中医经典还能倒背如流。

我们常常听人说某某人有中医童子功，指的就是由玺

印这样的人。青年时期的由玺印曾做过几年赤脚医

生，但是在文化大革命暴发后，他不再行医，毅然就

读了工程设计学校，成为一名工程设计师。

文化大革命期间，中医被认为是封建社会遗留下

的四旧之一。像由玺印这样的中医大家族遭受到了猛

烈的冲击，他家中珍藏的医书全部被堆在院子里进行

焚烧，由于古籍医书太多，烧书发出的浓烟几天几夜

才散尽。他的父亲也被拉走戴着牌子游街批斗。游行

时有村民偷偷把他父亲戴的牌子换成了一个纸糊的假

牌子，看着很大，份量却很轻。朴实的乡亲，用这样

的方式回报这位民间的良医，让人想哭又想笑，悲中

又有喜。由玺印的父亲被强制挂牌游街后不久，破四

旧立四新的红卫兵把他家中的大门当做封建迷信强行

拆除，几代人的家族文化遗产即刻间毁于一旦，父亲

趴在乱扔在地上的大门木板横梁上，像一个孩子样无

助地嚎啕大哭。由于伤心过度，几天之后气绝身亡。

父亲的死对由玺印打击很大，他决定不再行医。远走

他乡，学习工程设计。在工程设计领域，由玺印很快

就成长为一名高级工程师，收入颇丰，日子过得十分

滋润。但是他总觉得自己的生活少点儿什么。

文化大革命结束后，社会各界人民群众的日子

一天比一天好起来，新的社会疾病也一天比一天多。

忧郁症成为危及健康的新顽疾。由氏家族一位有威望

的远亲，最擅长的是给他人做思想工作，不知什么原

因，却患上了重度忧郁症，一段时间的自我折磨后，

最终选择以自杀的方式结束了自己的生命。消息传到

由玺印的耳里时，他十分震惊。昔日远亲爽朗的笑声

和给乡亲排忧解难的场景还历历在目，怎么人说没有

就没有了呢？况且，忧郁病也不是什么绝症！这位亲

戚的离世就像打开了一个坏消息的大门，接二连三，

又传来一些亲朋好友病重或病故的消息。从小扎根在

心里和浸入骨髓的医者意识，使由玺印认为：这些人

明明是可以救活的！就在这时，又一噩耗传来，家中

某位亲人的孩子得了白血病已躺在病床上奄奄一息，

全家人眼睁睁地看着这个孩子病逝，心如刀割，却无

能为力。从孩子在病床上最后的一段生命时光中，由

玺印清晰发现孩子的白血病症状和祖上医治的贫血病

十分相似，回想祖辈治病的过程和熟背的医书，及父

亲曾点悟他治疗贫血症的医理，他突然顿悟出治病药

方。他为孩子的病逝感到痛惜。由氏家族血脉中流淌

的济危救困的岐黄精神，无时无刻不提醒着由玺印：

今后的人生路，是不是要再次做医生？他在西安工作

时，一位重病的白血病女青年在朋友的推荐下找到由

玺印。患者知道他的家族世世代代的中医都有很高的

名望，患者恳请由玺印把她死马当活马医。患者把由

玺印当成生命中最后一根救命稻草。由玺印给她开了

药方，让她去抓三付药，试一下，如果有效就接着

吃，如果没有效就赶紧去找别的医生治。后来便没有

了女青年的消息。事隔几年后，一位中年妇女带着两

个孩子给他下跪感恩时，他才得知这个人就是几年前

自己无意间治愈的白血病患者！

由玺印能治疗白血病的消息不胫而走。治病救人

的责任感和使命感，使他果断放弃自己的设计专业，

再次开始踏上行医之路。由玺印说：“很多现代病虽

2020/02Ⅰ 67

然西医给取了一个高大上的名字，让人心存畏惧，但

是只要知道病因，找到病根，对症下药，治疗就会有

奇效。小时候常听爷爷对父亲说，不知病因的治疗等

于杀人！”爷爷的话也被他当成行医的最高准则。

由玺印1981年开始进行血液病的研究，在中医

药治疗血液系统疾病研究方面取得了突破性进展，于

2007年获得中药治疗白血病的国家专利，并于2008年

定居北京通州，专心从事血液病的中药研究。由玺印

认为，疗效是检验医学真理的唯一标准。真正的中医

疗效是标本兼治。

病因复杂踪难寻，找准病因须辨证

近古稀之年的由玺印，有着四十多岁中年男性的

精气神。他双目炯炯有神，话语铿锵有力，正气浩然

于胸。他说，急性白血病属于祖国医学“温毒”“热

劳”“血证”等范畴。慢性白血病根据其贫血虚

弱、肝脾及淋巴结肿大等表现，属于祖国医学“虚

损”“症浪”“底病”“痰核”等范畴。目前有学者

将白血病的病因病机归纳为三点：一是因实及病，久

病致虚；二是因虚致病，遂成虚劳；三是虚实交错，

虚证多见。通过对白血病进行研究分析后认为，除中

医理论中的内因和外在因素外，垃圾食品，环境污染

以及激素和抗生素的滥用，电离辐射等化学物理因素

均可致精气内虚伤及骨髓。上世纪60年代初期有学者

将白血病分为6个证型：阴虚型、阳虚型、阴阳两虚

型、瘀血型、痰热型和温热型。

由玺印则将白血病分为三类：一是毒入骨髓，

患者高热，大汗而热不解，出血，贫血，肝脾、淋巴

结肿大，头昏痛，一身骨痛关节痛，脉象洪大。该类

多见于青少年患者，表现为各种急性白血病或各种慢

性白血病急性发作期，起病迅速凶猛。二是肝肾同病

瘀毒，患者潮热盗汗，五心烦热，动辄激怒，全身乏

力，形体消瘦，肝脾肿大，以脾为甚，胸骨压痛或肋

处痛，脉象多弦数或细数。该类多见于慢性粒细胞性

白血病。三是脾肾两虚瘀毒类，发病较前两类缓慢，

面色苍白，头昏心悸，腰膝酸软，神疲乏力，胃口不

佳 ，肝脾或淋巴结肿大，舌淡少苔，脉象虚细。该类

多见于慢性淋巴细胞性白血病患者。

是什么样的病因引起白血病，就要用相应的对

症中药，这样才会疗效显著。有些人认为中医是“慢

郎中”，由玺印认为持有这种观点的人如果是中医从

业者，应该对中医再进行深入的学习。如果是业外人

士，那是对中医存在着误解。“中药不慢，对症的中

药3～5付药就能见效，如果药效慢到一两个月才能见

效，患者早不在人世了。”由玺印认为，中医药治疗

白血病的过程中不能用西医的相关指标衡量，患者在

病态中细胞指标一直在千变万化的不确定因素中，穷

追万变指标必然会耽误当下的紧急病情，关键要看患

者用药后精气神是否得到了及时改善。精气神俱足，

一切相关的生理指标自然会随之改善，即“正气内

存，邪不可干”。

由玺印认为，人体具有天人合一的整体性和系

统性，对于任何一个疾病而言，失去整体性和系统观

念盲目局部对抗，必定会失去医学的真实本意。中

医讲究平衡和谐，人体的疾病源于系统原有的平衡被

打破，所以《黄帝内经》认为疾病“或生于阴，或生

于阳”。在白血病的研究中，分析疾病产生的机制，

多种方式诊断探求病理，即“辨证”。中医诊病首先

是“望、闻、问、切”了解病情，辨表里、寒热、虚

实、阴阳的属性，然后根据病因、脏腑病位、气血津

液等病理变化，按证候属性，决定治疗方法，采用相

应的药物。唯有进行辨证找准病因，才能知己知彼，

百战百胜。

临床实践效如神，禅修功夫是秘密

由玺印有数十年的平心静修历程，他认为万病

皆由心生。虽说患者的病因十分复杂，但万变不离其

宗，心为其主。迄今为止，他所治疗的白血病患者

中，还没有是同一种病因导致的。而想找准病因，医

者必须进行禅修来提高自己的悟性，来正确判断相关

的疼痛机理。有禅修功夫的中医人更容易拥有找准病

因的智慧，如果一个中医人不禅修内养，即使聪明过

Cover clinical specialists｜ 封面名医

68 Ⅰ2020/02

临床名医｜Clinic Specialist

人也不过是“小聪明”而已。

现代中医人，生活压力大，日常的琐事繁多，

有一颗清净心的人少。这颗清净的心不可能凭空从天

而降，只有通过禅修才可以获得。禅修可以让人聚精

会神，心神不散乱。由玺印禅修的具体方法是：通过

打坐，调整呼吸，细心观察自身的心理状态，由静到

定，由定获得身心清净，并开启智慧。慧从禅中来。

禅修过程中的调身、调心、调息，可以使人的生

理和心理得到净化，人的生命会因此轻松愉快，生机

勃勃。通过禅修得到的智慧，能够帮助人们清除贪、

嗔、痴、慢、疑等烦恼。深层次的禅修所带来的智

慧，可以把这些烦恼消除，使生命进入真实与宁静，

使身体与心灵重新联结，在柔软和轻安中，使一个人

的生命拥有一股清净美好的神奇力量。

经历禅修的中医人，其心灵好似一面明镜，对病

人的病情可以洞察秋毫。由玺印在对白血病深入探索

的过程中，正是禅修让他在临床实践中，忠于客观事

实，他的立方用药也因此如有神助，疗效显著。关于

禅修，由玺印曾出版过一本专著《丹道养生大成》，

被社会各界公认是罕见传统正宗养生术。

满足健康新需求，中医中药有神威

中医是全科，白血病只是由玺印擅长治疗的现代

疾病的其中一种。找他治疗白血病的患者太多，并且

这些患者绝大部分是被西医治疗的倾家荡产、身无分

文，走投无路之后，才找到中医。很多白血病患者在

西医治疗时，还受到药源性二次伤害。面对众多困苦

的白血病患者，由玺印常常感到帮不过来。他希望他

的白血病中药组合物及其制备方法的专利，能尽早的

转化出来，让更多的患者受益。这是由氏家族几代人

行医的临床结晶，也是传统中医与现代科技的结晶。

他说：“治病重在辨证，中药在新时期要想展

现出生命活力则应该创新，创新的原则是满足新时期

民众健康需求。”由玺印指出，历代中医药大家丰富

的医疗实践证明，中药要想满足民众健康的需求，需

要在原本的基础上不脱离传统医学轨道再进行创新。

传统中药通常是去粗取精，在淬、烩、煅、炒、炮等

外形上制作。而创新发明则是从广义上研究其理论及

制药技术，对中药的服法、用法、制作技术、炮制辅

料、工艺流程进行革新，以适应和最大限度的满足现

代民众的需求。

安全和高品质，是由玺印最看重的两个方面。他

说，控制药品质量的关键在于药材质量及提取工艺的

技术标准。传统中药方剂基于标准煎剂，十分重视方

剂及单味中药的复方作用，常常是多方位严格控制原

料的内在质量。由玺印的发明不仅注重药材的选用、

提取、浓缩、干燥、成型等过程，还尽量避免主药指

标性成分的损失和破坏。他对产品稳定性进行严格控

制，以确保产品成型后的高品质。由于该发明继承了

煎剂的综合疗效，易吸收、显效快，又具备成药易贮

存、易携带、易服用的优点，同时克服了服用量大、

工艺不合理、成分破坏严重等缺点，所以专利申报十

分顺利。

由玺印认为，我国中药存在严重的产、学、研

脱节问题，很少有企业愿意在这方面投入，使中药创

新“说起来重要，做起来次要”。他认为，中医药创

新效果检验要花费巨大的人力、物力，用西医指标对

中医药理论进行验证与说明是不妥当的。对中医药的

肯定和利用，应该由“重实验、轻临床”转向“重临

床、轻实验”，即回避空头理论，用实效说话才是医

学本质所在，对中医药的所谓创新，必须在了解中医

药后，在自身开悟的基础上进行创新。否则，只利用

一点局限性的自我水平来对文化底蕴深厚的中医药进

行创新，反而破坏了中医的形象。

由玺印希望国家相关职能部门能利用中药专利促

进中药技术进步，增强中药在国内外市场的竞争力，

并将中药技术研究与专利相结合，研究国际专利法规

及申报技巧，组织专业技术人员与专家共同探讨并制

定保护措施，促进中药走向国际医药主流市场。

笔者衷心希望由玺印发明的“治疗白血病的中药

组合物及其制备方法”的专利，能够在有识之士的资

助下，尽早化成甘霖，给社会上的白血病患者们及时

送去健康的福音。

2020/02Ⅰ 69

Chen Yuanwei, doctors must have a benevolent heart

◎Li Shanju

Excellent folk practitioners of traditional Chinese

medicine are pearls scattered in the world. Chen Yuanwei

is undoubtedly the most dazzling one in Zunyi, Guizhou.

He is radiant, like an uncontested great virtue hermit,

silently protecting the health of the grassroots people.

Good Chinese herbal medicine, good

prescription, good therapeutic effect

Chen Yuanwei gave himself the WeChat name

"Qianbei Grassroots Doctor", which means a private doctor

who specializes in treating ordinary people. However, his

patients are not only ordinary people, but also many highranking officials living in provincial and capital cities, as

well as many foreign patients from Germany, Italy, Japan,

the United States, and South Korea.

Chen Yuanwei is in the folk countryside, but his

medical skills and herbal medicine are advancing with the

times, and it is his responsibility to meet the health needs

of the people. For example, traditional Chinese medicine

is troublesome and the decoction is difficult to swallow.

Chen Yuanwei purchased modern western medicine

pharmaceutical equipment and made Chinese medicine

raw materials into capsules and tablets.

When you approached his Chinese herbal medicine

room and took a sharp look, there were small bottles and

boxes similar to western medicines in your eyes. You

thought it was western medicine. A closer look reveals

that they are all Chinese herbal medicines made from

raw materials of Chinese medicine in accordance with

modern western medicine. According to the different

conditions of the patients, he combined different Chinese

patent medicines and gave them to the patients. Don't

underestimate the Chinese patent medicines processed

by these individuals. They are all made with the addition

and reduction of medicinal flavors on the basis of classic

prescriptions. Taking the treatment of colds as an example,

colds can be divided into wind-cold cold and windheat cold. However, whether it is to treat wind-cold cold

or wind-heat cold, Chen Yuanwei here only uses a pill

composed of several Chinese medicine raw materials. As

long as you take a few tablets at the beginning of a cold,

you can get relief at a time. There is no such thing as a

saying that it takes a week to treat a cold.

When the new crown epidemic broke out in the

spring of 2020, Chen Yuanwei asked the villagers

to use this tablet to prevent colds, and the effect was

excellent. This approach of Chen Yuanwei not only

fully retains the advantages of personalized and tailormade prescriptions of traditional Chinese medicine, but

also adds the advantages of modern western medicine

quantitative concepts. While the advantages of traditional

Chinese medicine are not discounted, the bright spots of

western medicine are added. It not only overcomes the

shortcomings of the popularization of western medicine

without individual specificity, but also overcomes the

shortcomings of traditional Chinese medicine. For those

patients who know how to decoction and are willing to

decoction, they still prescribe authentic herbal decoctions.

Different from traditional Chinese medicines in other

Outstanding medical experts ｜杏林英才

70 Ⅰ2020/02

临床名医｜Clinic Specialist

places, most of the traditional Chinese medicines used

by Chen Yuanwei here are collected by his family and

disciples in the mountains, or purchased from villagers

near the primeval forest. The Chinese herbal medicines

he stocked filled the warehouse of nearly 1,000 square

meters. Chinese herbal medicine is good, the prescription

is good, and the effect is good. Together, it is really good

to be Doctor Chen Yuanwei.

Hello, hello, hello everyone

Traditional Chinese medicine is a general

practitioner, and Chen Yuanwei is a typical representative

of general practitioners. You can’t say that he is good at

seeing that kind of disease. It seems that modern people’s

diseases range from common children’s gynecological

trauma to many difficult diseases such as heart disease,

hypertension and tumors. , He can be treated. The effect

is amazing. In order to facilitate medical treatment for

patients from afar, Chen Yuanwei converted some idle

houses on the outskirts of Suiyang into hotel-like rooms,

and equipped them with kitchen utensils. Patients can cook

their own meals and have meals with Chen Yuanwei's

family. Chen Yuanwei called this place "Tianyuan Health

Care Center". The health centers in many places were born

under the planning of the person involved, but his health

center was born naturally to meet the needs of patients. It

is really hello, hello, everyone.

Since mankind entered the 1990s, the aging of the

population has become increasingly serious. Relevant

data show that in 2016, China's population aged 60 and

above accounted for 13.26% of the total population,

2.93% higher than that in 2000. The number of elderly

people with chronic diseases and empty-nest elderly both

exceeded the 100 million mark in 2013. Related agencies

predict that by 2025, China's population of people over 60

years old will reach 300 million, making it a super-aged

country. However, the Chinese pension market has not yet

formed a standardized system and model. Chen Yuanwei's

health care center provides useful lessons for latecomers.

In China, people often equate health care and elderly

care industries. There are basically three types of elderly

care industry: family care, community care and institution

care. The main models are "combination of medical

care", "combination of health care" and "combination

of medical care". "Combination of medical care and

elderly care" realizes the docking of medical and elderly

care services, but the post-rehabilitation treatment for

some semi-disabled and disabled elderly people is not

perfect; "Combined medical care" is usually located in

medical institutions and rehabilitation institutions. It is

not integrated into the daily life of the elderly at home,

and lacks the services, facilities and environment for the

elderly life, so it cannot meet the needs of "nourishment";

the "combined health and nurture" lacks the doctor team

and medical facilities of professional medical institutions,

and suffers from illness The elderly are often unable to

receive timely diagnosis and treatment. In view of the

above, Chen Yuanwei integrated the three modes of

"medicine and health care", "healthcare and health care"

and "medicine and health care" to form an integrated

model of "medicine, health care and health care". This

model solves the problems that hospitals cannot provide

for the elderly, nursing homes cannot treat diseases, and

families cannot take care of them.

The magic weapon for a lifelong career

Chen Yuanwei's relationship with Chinese medicine

is inevitable by accident. Chen Yuanwei has his magic

weapon to build a career based on traditional Chinese

medicine. This magic weapon is what his mother taught

him when he first studied medicine.

Chen Yuanwei also had an older brother ten years

2020/02Ⅰ 71

older than him. In 1952 or 1953, he had just graduated

from the Political Department of Southwest Revolutionary

People’s University and suffered from bronchial lung

cancer. The government sent his brother to the best

hospital in Beijing at that time, but he died in the end.

Chen Yuanwei's grandfather was Weng Guqiu, a

famous Chinese medicine doctor in Chengdu before and

during the early liberation period. After learning about

this, he and Chen Yuanwei's mother suggested that Chen

Yuanwei should learn Chinese medicine from him.

Before Chen Yuanwei went to Chengdu to study

medicine, his mother called him to the bed and asked

him if he knew: "Doctors must have a loving heart?"

Chen Yuanwei said I didn’t know, and his mother told

him the source of the allusion: ancient times , There is an

old Chinese doctor, a patient is sick, and he asks him for

treatment. There is a herbal introduction "human flesh" in

the prescription prescribed by the doctor. The doctor was

afraid that the patient could not find human flesh, so he cut

a piece of flesh from his leg and used it for the patient's

family. The saying "Doctors must have a loving heart" has

been around since then. My mother said to Chen Yuanwei:

"To tell you this allusion today, I don’t want you to cut

off your own flesh to make medicinal primers for patients

in the future. I want you to remember one thing. People

who study medicine should learn ethics first. To study

medicine, you must have an empathy with the patient and

sit in the position of the patient to think about the problem.

Then what questions will the patient think about? Three

questions: one, hope that the disease can be cured. Two,

hope that it will be faster. , I hope to save a little money.

If you say that the purpose of your medical study is to get

the money in the patient’s pockets into your own pockets

after you have mastered the techniques, you will never be

a good doctor. "My mother’s teaching of Chen Yuanwei,

Affected his life. Today, all the patients seeing Chen

Yuanwei are like seeing relatives who have reunited after

a long absence.

Enlightenment when life is dark

During his youth, Chen Yuanwei was detained for

two years. It was the period of the Cultural Revolution,

and there were big-character posters everywhere. When

Chen Yuanwei wrote "Long live Mao Zedong Thought",

he made a clerical error and missed the word "East". It

was pronounced as "Long live Mao Zedong Thought".

Because of the similar pronunciation of "Mao Ze" and

"Mao Lao" in Guizhou dialect, Chen Yuanwei was

detained for two years. In the past two years, apart from

reading philosophy books and medical books, all were

isolated from the world. In the past two years, Chen

Yuanwei once again studied classics of traditional Chinese

medicine such as Treatise on Febrile Diseases, and studied

philosophical works such as Marx and Mao Zedong

Thought. He found that using philosophical concepts

to learn, research and apply Chinese medicine is very

beneficial.

Someone asked Chen Yuanwei: Is he full of hatred in

his heart because he was detained for two years because

he missed a word? He said sincerely from the heart: No.

He said that if it were not for the past two years, he would

not have such ample time to "deep research on Chinese

medicine" and "deep research on philosophy." For others,

the past two years have been a disaster of imprisonment.

For him, the past two years have been the prime time for

"cultivating the Tao", especially the successful "getting

the Tao".

Chen Yuanwei now has his own "Tianyuan Health

Care Center" as well as a Tianyuan winery. In the 1990s,

his Jiujiu Tianyuan wine was as famous as Kweichow

Moutai, which is now well-known overseas. It is not

only designated for use by some local government

agencies, but also popular in Hong Kong. The reason why

Outstanding medical experts ｜杏林英才

72 Ⅰ2020/02

临床名医｜Clinic Specialist

Tianyuan Wine was so popular at that time was that it

helped the Chinese National Weightlifting Team achieve

unprecedented results in many important events. In 1995,

the national weightlifting team was in a low period, and

its performance was stagnant. According to a person from

the National Sports Commission, Mr. Chen Yuanwei, the

producer of Tianyuan Wine, sponsored this wine for the

National Weightlifting Team. The national weightlifting

team first sent the wine to the National Doping Testing

Center for doping testing. As a result, Tianyuan wine does

not contain any stimulants, hormones and antibiotics,

which meets the strict requirements for athletes to drink.

Subsequently, the national weightlifting team conducted

a one-month trial. At that time, dozens of male athletes

participated in the trial, and individual athletes generally

improved by 5-10 kg! Subsequently, at the Guangzhou

World Weightlifting Championships held at the end of

1995, he won five gold, five silver, six bronze and the first

in the team total score, making a historic breakthrough!

The previous national weightlifting team's performance

was ninth in the group. The national weightlifting team

fully affirmed the three major effects of drinking Tianyuan

wine: one is that the team members fall asleep quickly

and sleep normally; the other is to recover from training

fatigue and play a good role in persisting in large-volume

training the next day; third is to increase Athlete muscle

strength training plays a very good role. With the help of

Tianyuan Wine, the national weightlifting team achieved

brilliant results in Atlanta in 1996 and Sydney in 2000.

Mr. Chen Yuanwei has never regarded himself as a

winemaker, let alone a businessman, because he felt that

his true identity was a doctor, and Tianyuan wine was just

one of his weapons for healing and saving people. Related

research found that Tianyuan wine contains 8 kinds of

essential amino acids and 11 kinds of non-essential amino

acids. Among them, arginine can improve the vitality of

lymphocytes and phagocytes, activate the cellular immune

system and regulate immune function.

Tianyuan Feed Additives and Tianyuan Feed are byproducts when Mr. Chen Yuanwei developed Tianyuan

Wine. The breeding experiment was carried out on

chickens and pigs in the experimental breeding farm of

the institute. The test results show that the weight gain of

the monomer is similar or higher than that of the existing

compound feed and the conventional farm feed; the meat

quality of livestock and poultry has obvious advantages,

and the ability to resist disease is strong; More lean meat,

less fat, and thin eggshells. The test results show that

the developed TY-I TY-II functional compound feed has

reached the expected five goals.

Not many people know about Tianyuan Feed

Additives and Tianyuan Feed. These two treasures born

from the research and development of Tianyuan wine have

been in the boudoir for 20 years. Chen Yuanwei looks

forward to the people who are destined to come together

and form an alliance between the Qin and the Jin Dynasty

for the benefit of To the people, create greater social value.

Conclusion

Chen Yuanwei is ordinary, but Chen Yuanwei is not

ordinary. He never said that he would inherit and innovate

Chinese medicine, but he naturally inherited and innovated

Chinese medicine. There is no relevant organization to

commend him, but he is deeply loved by patients all over

the country. In addition to the role of a doctor, he has his

own winery, pig farm, and chicken farm. The words of the

"heart of love" that his mother said when he was a child

helped him settle down, establish a career, and establish a

virtue. He has accomplished himself and blessed others.

2020/02Ⅰ 73

陈远维：医家要有“割股之心”

◎李善举

优秀的民间中医，是散落在人世间的珍珠。陈远

维无疑是贵州遵义地区最耀眼的那颗，他光芒四射，

像一位与世无争的大德隐者，默默护佑一方基层百姓

的健康。

药好、方好、疗效好

陈远维给自己取的微信名是“黔北丐医”，意为

专给普通老百姓看病的民间医生。但是他的患者不仅

仅普通老百姓多，身居省城、京城的“达官贵人”也

很多，还有众多慕名而来的德、意、日、美、韩等外

国患者。

陈远维虽身处民间乡野，但他以满足老百姓健

康需求为己任，在医疗和药物方面保持与时俱进。传

统的中药煎熬麻烦，汤药难以下咽，陈远维就购买引

进现代化的西药制药设备，把中药原料制成胶囊和药

片等中成药。走近他的药房，猛一看，满眼是类似西

药的小瓶、盒子，让人以为是西药，仔细一看，竟全

是由中药原料制成的西药状中药片。他根据病人病情

的不同，把不同的中成药进行组合后，给患者使用。

不要小看了这些手工制作的中成药，其实都是在经方

的基础上增减药味制成，别看模样普通，但都在延续

中国传统医学的血脉。以治疗感冒为例，中医分风寒

感冒和风热感冒，但是不论是治疗风寒感冒还是风热

感冒，陈远维只用数种中药原料合成的药片，让患者

在感冒初期吃几片，就能很快见效，他这里没有“治

疗感冒需要一周时间”的说法。2020年春季，新冠疫

情暴发时，陈远维让乡亲们用这种药片预防感冒，效

果极佳。陈远维的这种做法，既完整保留了中医个性

化量身定做的开药优势，还加进了西药“清清爽爽”

的优势。在中医药优势不打折的同时，加进了西药的

亮点。既克服了西药普适大众化没有针对性的缺点，

还克服了中医难熬难吃的缺点。而对于那些会煎药、

愿意煎药的患者，则还是会开出传统的草药汤剂。与

别的地方的中药材不同的是，陈远维这里的中药材大

多数是家人和弟子们在山里面采挖而来，或是从原始

森林附近村民的手中收购而来。他囤积的中草药，装

满了近千平米的库房。药好，方好，疗效好，加在一

起，成为陈远维医生的“法宝”。

你好、他好、大家好

中医是全科医生，陈远维是全科医生的典型代

Outstanding medical experts ｜杏林英才

74 Ⅰ2020/02

临床名医｜Clinic Specialist

表，并不能说他不擅长看哪种具体疾病，然而，从常

见中医的内、外、妇、儿，到诸如心脏病、高血压、

肿瘤等疾病，他都可以治疗。效果还让人赞叹。为了

方便远道而来的患者就医，陈远维把绥阳郊区的一些

闲置的房子改装成类似旅店的风格，并配套了厨房用

具，患者可以自己动手做饭菜，还可以和陈远维一家

人一起进餐。陈远维把这个地方称之为“天源康养中

心”。很多地方的康养中心，是当事者策划诞生，而

他的这个康养中心，是为了满足患者需要，自然而然

地生成，真是你好，他好，大家好。

进入20世纪90年代以来，全球人口老龄化日趋严

重。相关数据显示：2016 年，我国 60 岁及以上人口占

总人口的 13.26%，比 2000 年高出 2.93%，慢性病患

病老年人和空巢老年人人口数量在 2013 年均突破 1 亿

人大关。相关机构预测，2025 年我国 60 岁以上老年

人口将达到 3亿，成为超老年型国家。然而，我国养

老市场还没有形成一个规范性的体系和模式。陈远维

的康养中心，给后来者提供了有益的借鉴经验。

在我国，人们常把康养和养老产业划等号，养老

产业基本是存在三大类型：家庭养老、社区养老和机

构养老。主要模式为“医养结合”“康养结合”“医

康结合”三种。“医养结合”实现了医疗和养老服务

的对接，但是对于一些半失能、失能老年人的后期康

复治疗却不完善；“医康结合”，由于其服务地点通

常在医疗机构和康复机构，没有融入老人的日常居家

养老生活中，并缺乏养老生活的服务、设施和环境，

所以也无法满足“养”的需求；“康养结合”，由于

缺乏专业医疗机构的医生团队和医疗设施，患病老人

往往无法得到及时的诊治。鉴于上述，陈远维把“医

养结合”“康养结合”“医康结合”三种模式整合在

一起，构成了“医康养”一体化模式。这一模式解决

了医院不能养、养老院不能医、家庭无法护的难题。

安命立业一生的法宝

陈远维跟中医结缘，是偶然当中的必然。陈远维

凭借中医药安命立业，有他的法宝。这法宝就是他学

医之初母亲教导他的一席话。

陈远维的上面还有个哥哥，比他大十岁，上世纪

50年代初，从西南革命人民大学政治系刚刚毕业，就

患了支气管肺癌。当地政府送他的哥哥去北京当时最

好最好的医院治疗，但最终还是不治身亡。

陈远维的外祖父叫翁古秋，是解放前和解放初期

时成都的名中医，知道这件事后，和陈远维的母亲建

议，让陈远维去跟他学中医。

陈远维去成都学医之前，母亲把他叫到床面前，

问他是否知道,医家要有“割股之心”。陈远维摇摇

头。母亲就给他讲这个典故的出处：古时候，有位老

中医，病人请他诊治。医生开出的药方中有一味药引

子——“人肉”。医生怕病人找不到人肉，就把自己

腿上的肉割了一块下来，给这个患者家属用。医家要

有“割股之心”的说法，就是从这时开始有的。母亲

对陈远维说：“今天给你讲这个典故，并不是希望以

后你把自己的肉也割了给病人做药引子，是要你记住

一点，学医先学德，医生要和病人有一个换位思考，

坐在病人的位置上思考问题。那么，病人会想些什么

问题呢？三个问题：一，希望把病治好。二，希望好

快一点。三，希望钱省一点。如果说你学医的目的，

是想把技术学到手后，把病人兜里的钱搞到自己兜里

来，你永远不会是个好医生。”母亲对陈远维的教

导，影响了他的一生。今天，所有的病人见到陈远

维，就像是见到久别重逢的亲人。

人生至暗时悟道

青年时期的陈远维被关过两年禁闭。那是文化

大革命时期，到处是大字报，大放大鸣。陈远维在写

“毛泽东思想万岁”时，出现了笔误，少写了一个

“东”字，被人念成“毛泽思想万岁”，由于贵州方

言中“毛泽”和“茅厕”的发音相似，陈远维被关押

了起来，一关就是两年。这两年中，除了能看哲学书

和医书外，精神世界几乎与世隔绝。在这两年中，陈

远维再次深研了《伤寒论》之类的中医经典著作，并

且深入学习了马克思主义、毛泽东思想等相关理论著

2020/02Ⅰ 75

作。他发现用哲学观念来学习、研究和运用中医，受

益颇深。

有人问陈远维：因为少写一个字被关了两年，内

心是不是充满了仇恨？他发自内心真诚地说：没有。

他表示，如果不是这两年，他不会有这么充裕的时间

“深研中医”，并“深研哲学”。在别人看来，这两

年是牢狱之灾，对他而言，这两年是“修道”的黄金

时间，尤其是成功地“得了道”。

现在的陈远维，除了有自己的“天源康养中

心”，还有一个天源酒厂。他的九九天源酒在上世纪

90年代，曾与当今蜚声海外的贵州茅台酒齐名，不仅

是一些地方政府机构指定用酒，还在香港地区热销。

天源酒之所以在那时受到如此热捧，是因为这款酒助

力中国国家举重队在诸多重要赛事中取得了前所未有

的好成绩。1995年，国家举重队处于低谷期，成绩徘

徊不前。经国家体委相关人士介绍，天源酒的酿造者

陈远维先生赞助了国家举重队这款酒。国家举重队首

先将酒送到国家兴奋剂检测中心进行兴奋剂检测，其

结果是天源酒不含任何兴奋剂、激素和抗生素等，符

合运动员饮用的严格要求。随后，国家举重队进行了

一个月的试验，当时数十名男运动员全部参加了试

验，单项成绩运动员普遍提高了5～10公斤！随后在

1995年底举行的广州世界举重锦标赛上，获得了五

金、五银、六铜及团体总分第一的好成绩，取得了历

史性突破！之前国家举重队的成绩是团体第九名。国

家举重队充分肯定了饮用天源酒的三大作用：一是队

员入睡快，睡眠正常了；二是对恢复训练疲劳，对第

二天坚持大运动量训练起到很好作用；三是对增加运

动员肌肉力量训练起到很好作用。在天源酒的助力

下，国家举重队在1996年亚特兰大和2000年悉尼奥运

会上取得了辉煌的成绩。

陈远维先生从没有把自己当成造酒人，更没有把

自己当成一个商人，因为他觉得自己的真正身份是医

生，理应悬壶济世，天源酒只是他治病救人的利器之

一。相关研究发现，天源酒中含有8种人体必须的氨

基酸和11种非必需氨基酸，其中精氨酸具有提高淋巴

细胞、吞噬细胞活力的作用，能激活细胞细胞免疫系

统，调节免疫功能。

天源饲料添加剂和天源饲料是陈远维先生研发

天源酒时的副产品。饲养试验在研究所实验养殖场以

鸡、猪为对象进行。试验结果表明，单体增重相似或

高于现有配合饲料和农家常规饲料；畜禽肉质具有明

显优势，抗病变能力强；肉、蛋口感鲜、香，肉质紧

密细嫩，猪肉皮薄、瘦肉多、肥肉少、蛋壳薄。 试验

结果表明，所研制的TY-I型TY-II型功能型复合饲料

达到了预期的五项目标。

天源饲料添加剂和天源饲料知道的人并不多，这

个因研发天源酒而诞生的两个“宝贝”待字闺中已经

有二十年，陈远维期待有缘人来珠联璧合，结秦晋之

盟，从而造福于民，创造更大的社会价值。

结语

陈远维很普通，但是陈远维又不普通。他从没有

说过要对中医进行继承和创新，但是他自然而然、润

物无声地对中药进行了继承和创新。没有相关机构对

他进行表彰，但是他深得全国患者的厚爱。在医生这

个角色之外，他有属于自己的酒厂、猪场、鸡场。母

亲在他小时候说的“割股之心”的典故，让他安身、

立业、立德。既成就了自己，也福泽了他人。

Outstanding medical experts ｜杏林英才

76 Ⅰ2020/02

临床名医｜Clinic Specialist

Zhang Jinbo, Chinese medicine has the effect of "covering the

cup" in treating insomnia

◎Li Shanju

Insomnia refers to sleep disorders, which is a

common physical and mental illness of modern people

in modern society. Traditional Chinese medicine in the

motherland calls insomnia "not looking at sight" or

"insomnia". Insomnia is not only high in the elderly,

but also common in middle-aged men and middle-aged

women in cities, which seriously interferes with people's

normal work and life. Zhang Jinbo is the director of the

"Preventive Treatment" Center of Yantai Hospital of

Traditional Chinese Medicine and a special clinical expert

of Chinese medicine at Beijing University of Chinese

Medicine. He has won praise and trust from many patients

in treating insomnia. Zhang Jinbo has proved with a lot of

clinical practice: TCM has the effect of "covering the cup"

in treating insomnia.

Don't use jujube seed as a "sedative" medicine

When Zhang Jinbo came to the Traditional Chinese

Medicine Clinic of Beijing University of Traditional

Chinese Medicine from Yantai, there were very few

patients in the clinic. However, since the treatment of a

long-term insomnia Tianjin aunt, the number of patients

has begun to surge, and one third of the outpatients are

insomnia patients.

This 70-year-old woman in Tianjin has had insomnia

for more than 30 years. She has been using sleeping pills

for a long time to fall asleep at night. As she gets older,

her insomnia becomes more and more serious. As long

as there are new sedatives on the market, this aunt will

become the first group of drug users. Before receiving

Zhang Jinbo's treatment, Tianjin aunt will not only take

the latest sedatives but also antidepressant drugs. In the

words of Tianjin Auntie, sleeping pills have a certain

effect of helping sleep, but they can only be regarded as

maintenance, not as being cured. When Tianjin Auntie's

mood fluctuates, these sleeping pills will be ineffective.

Over the years, Tianjin Auntie has a pale complexion,

her mind is dizzy during the day, she has no energy, she

is forgetful about doing things, she loses her appetite and

loses her appetite when eating, and she is very painful.

Under normal circumstances, it is difficult for her to fall

asleep. After falling asleep, she usually wakes up an hour

later. After waking up, she can't sleep again.

Zhang Jinbo prescribed seven pairs of Chinese herbal

medicines to Tianjin Auntie. The old lady asked before

leaving, "Do my sleeping pills stop?" Zhang Jinbo said,

"Don't stop. You have been dependent on sedatives for so

many years. You can't stop them all at once. After eating

Chinese herbal medicines, slowly reduce the amount."

Aunt Tianjin would like to follow the doctor’s advice.

When the second Chinese herbal medicine worked, she

began to slowly reduce the amount of sedatives. On the

night of the last Chinese herbal medicine, she wanted

to see what would happen if she did not take western

sedatives. Still slept well. The old lady has poker friends,

drinking friends, and patient friends. She shared her joy of

getting a good doctor in a group of patients, who all like

to pass on word of mouth. When Tianjin Aunty returned

to the clinic, she brought seven patients with insomnia to

Zhang Jinbo.

Zhang Jinbo told Qihuang Chuanren's column that

with the popularization of Chinese medicine knowledge,

whether it is Chinese medicine or Western medicine,

2020/02Ⅰ 77

many doctors like to use wild jujube seed to make Chinese

herbal medicine when they encounter insomnia. Some

patients have an effect, but most patients have no effect. .

Why is there no effect in some patients with jujube seed?

Because people are different, the causes of insomnia are

different, and the treatment methods and Chinese herbal

medicine should also be different.

Many Chinese medicine practitioners think that it

is a sedative. Some people even use up to 100 grams of

fried jujube seed to treat insomnia, but it still cannot cure

insomnia. Because wild jujube seed is not a sedative, it

cannot cure all kinds of insomnia. Jujube seed nourishes

liver blood, which can nourish liver yin. The liver

belongs to wood among the five elements. If wood does

not make fire, it will not disturb the mind. If your mind

is not disturbed, people will be at peace, as long as they

are at peace, they will sleep. The ancients used wild

jujube seed to nourish blood, nourish yin and soften the

liver, and prevent the lack of liver yin and blood from

starting a fire. After the fire becomes strong, it disturbs

the mind. This is the principle used by the ancients to

treat insomnia with fried jujube seeds, and it has a certain

range of applications. If jujube seed is used as a sedative,

500 grams of jujube seed is not as sedative as a bottle of

diazepam. One diazepam only costs a penny. How much is

100 g of jujube seed? This is from the economic point of

view. From the point of view of curative effect, it cannot

be considered as a sedative. TCM treatment of insomnia

is not based on sedation. In the treatment of insomnia

with traditional Chinese medicine, only by identifying the

cause of the disease and seeking the root cause can it be

effective.

Mechanism of TCM Differentiation and

Treatment of Insomnia

Chinese medicine believes that insomnia is caused

by the imbalance of yin and yang in the body. But yin and

yang are a big concept in Chinese medicine, and almost

all diseases are caused by the imbalance of yin and yang.

Insomnia is essentially that the yin and yang of the body's

meridians cannot embrace each other. Ancient Chinese

medicine believed that when yang qi enters yin qi, one

will sleep soundly, and when yang qi flows out of yin qi,

one will wake up. When we treat insomnia, we must think

of nourishing yin and restraining yang so that yang can

enter yin.

In the treatment of insomnia in traditional Chinese

medicine, it is necessary to grasp the time period of

insomnia of the patient, and the reasons for insomnia

are different at what time period. Traditional Chinese

medicine has a very fine division of the viscera, such as

heart yin, heart yang, kidney yin and kidney yang, liver

yin and liver yang. Is the patient’s insomnia caused by

the loss of balance between heart yin and heart yang, or

liver yin and liver yang. Whether the loss of balance is

caused by the imbalance of spleen yang and spleen yin, or

the loss of balance between kidney yin and kidney yang,

depends on the patient's pulse image.

Depending on the situation, the prescription

and medicine prescribed by the doctor are different.

Traditional Chinese medicine pays attention to syndrome

differentiation and treatment. Different Chinese herbal

medicines have different prescriptions. There is no

fixed prescription for the disease, and the doctor always

formulates the prescription according to the disease.

Suppose there is a patient with insomnia who wakes

up at 12 o’clock at night and can’t sleep anymore. At

this time, the hour belongs to the Zishi, Zidan, the gall

bladder meridian is in Shaoyang, Shaoyang moves,

causing fire, disturbing the mind and confusion. disturbed.

We treat according to the syndrome differentiation of

Chinese medicine. At this time, Shaoyang fires strong

and Shaoyang is easy to move. We use Chaihu Shugan

Decoction to reconcile Shaoyang. It is to soothe the

liver and relieve Shaoyang, plus some Chinese herbal

Outstanding medical experts ｜杏林英才

78 Ⅰ2020/02

临床名医｜Clinic Specialist

medicines that help sleep, basically a few Chinese herbal

medicines can solve the patient's problem.

The causes of insomnia are different for men and

women, and for old and middle-aged people. Generally

speaking, women who suffer from insomnia should start

with the liver, because most women suffer from spleen

deficiency and liver depression, which will turn into fire

for a long time. Women generally need to relieve the

liver, relieve depression, invigorate the spleen and soothe

the nerves. Men should start with the kidneys, and men

generally suffer from kidney deficiency. The elderly need

to replenish qi and blood.

Zhang Jinbo pointed out that sometimes a word of

the patient is the valuable diagnostic information of the

doctor. For example, patients often dream of fighting or

dueling, which is generally arousing anger. Dreaming

of always flying up, generally considered to be full of

energy, dreaming of always falling from high altitude,

Chinese medicine thinks it is kidney deficiency. Always

dream of some trivial things in life, that is, the spleen is

weak. When thinking too much hurts the spleen, it’s easy

to dream of lingering dreams, and sometimes there will

be dreaming dramas. The dreams I had last night can be

continued tonight from yesterday. This is thinking too

much hurts the spleen. Our Chinese medicine doctors

think it is concerning. Because of the spleen idea, he is

very concerned about some problems. Caring is about

thinking. Traditional Chinese medicine generally uses

the spleen to nourish the heart. At this time, we need to

use Guipi Decoction, which is sad and fearful. We use

different prescriptions. Men always dream about water,

which is usually caused by kidney problems. According to

Chinese medicine, it may be caused by prostate problems

or bladder meridian problems.

However, in the treatment of insomnia, Chinese

medicine is not a panacea. Medication is not as good

as diet therapy, and diet therapy is not as good as

psychotherapy. The so-called psychotherapy is the use of

health rules, such as exercise. In the daytime, try to get

yourself excited and sweat. When you exercise and sweat,

the meridians of your body will open and close. When you

sweat, you will be relieved. When all the meridians are

running smoothly, the energy of the meridians will flow

in and out on time. Yin and Yang can hug each other in

time. Therefore, sweating during exercise during the day

is also a good way to solve sleep problems. This is not a

medicine therapy, this is a traditional Chinese medicine

method, also called natural therapy. As long as you know

how insomnia is caused and find the cause of insomnia,

any method can be used to cure it. There is no fixed

method. Does traditional Chinese medicine have to use

medicine to treat diseases?

Introduction to Zhang Jinbo:

Male, born in 1964, master tutor of Shandong

University of Traditional Chinese Medicine, special clinical

expert of Beijing University of Traditional Chinese Medicine.

He brought into play the theory of "all qi and depression,

all belong to the lung" in the "Internal Classics'', and refined

the dialectical and therapeutic thinking of "declaration

and transparency"; he proposed ten methods of declaring,

transparent, rectifying, opening and closing, and opening and

closing to cure diseases It is believed that the meridians of the

whole body are dependent on the three energizers, attached to

the fur, the lungs are depressed, and the occlusion of the Xuan

Mansion is the main pathogenesis. He authored "Xuanming

Medicine Heart Method''. He put forward the academic view

that the numbness is outside, the dysfunction is inside, the

swelling is inside, and the disease is outside. He invented

the method of picking through the meridian, enriching the

scope of the external treatment method; he declared the

transparent Xuanfu, and used Jinpingmu to treat liver disease

; He proposed that the viscera, blood vessels, meridians, and

limbs also have appearances, and they all have a new view

of the lung owner, and innovated a new theory of "resolving

the appearance and expanding the collaterals". He sits in

expert outpatient clinics in the Traditional Chinese Medicine

Hall of the hospital. There are an average of more than 70

outpatients per day, with a maximum of more than 100

visits. Many medical seekers come from Beijing, Shanghai,

Nanjing, Jinan, Guangzhou, Shaanxi, Chongqing, Northeast

China, Xinjiang and Inner Mongolia. , Overseas Chinese, and

overseas and international friends from the United States,

Canada, Japan, South Korea, etc., have created a huge social

impact on the outpatient service at twelve o'clock in the

morning and even the first afternoon in the first afternoon,

registration, and appointment registration two months ago.

2020/02Ⅰ 79

张金波：中医治失眠有“覆杯”之效

◎李善举

失眠是指睡眠障碍，是现代社会的一种常见身

心疾病，祖国传统中医将失眠称之为“目不瞑”“不

寐”。失眠不仅在老年人群中高发，在都市里的中年

男性和中年女性群体中，也很常见，严重干扰了人们

的正常工作和生活。张金波是烟台市中医医院“治未

病”中心主任，也是北京中医药大学中医临床特聘专

家，在治疗失眠上，赢得了众多患者的称赞和信赖。

张金波用大量的临床实践证明了：中医治失眠有“覆

杯”之效。

莫把酸枣仁当“镇静”药

张金波初到北京中医药大学国医堂出诊时，门诊

室里的患者十分稀少。然而，自从医治了一位从分诊台

引导 过来的长期失眠的天津大妈之后，患者应诊量开始

暴增，门诊量三分之一的患者都是失眠病人。

一位七十多岁的天津大妈，失眠已经有三十多

年了，夜晚入睡长期以来用安眠药维持，随着年龄的

增长，失眠越来越严重。市场上只要有新的镇静药

出现，这位大妈就会成为第一批用药人，天津大妈

在接受张金波治疗前，不仅吃最新的镇静药，还吃

抗抑郁的药。用天津大妈的话说，安眠药有一定的助

眠效果，但是只能算是维持，不能算是被治愈。天津

大妈情绪出现波动的时候，这些安眠药就会处在失效

状态。这么多年来，天津大妈面色萎黄，白天头脑昏

沉，浑身没有力气，做事情健忘，丢三拉四，吃饭越

来越没有胃口，十分痛苦。她一般情况下很难入睡，

入睡以后，通常是一个小时后就醒，醒了之后就再也

睡不着觉。

张金波给天津大妈开了七剂药，老太太临走时

问，“我的安眠药停吗？”张金波说：“你先别停，你

吃这么多年的镇静药，已经有依赖，一下子停掉不行，

吃中药见了效以后，慢慢的减量。”天津大妈谨遵医

嘱，第二剂药见效时，她就开始把镇静药慢慢地减量，

到吃最后一剂中药的那个晚上，她想试试不吃西医镇静

药会怎么样。结果，她照样儿睡得挺好。老太太有牌

友、酒友，还有病友。她在一个病友群中分享了自己得

遇良医的喜悦，病友们如获福音。天津大妈复诊时，一

下就给张金波带来了七位失眠病友。

张金波告诉歧黄传人专栏采访者，随着中医知识

的普及，不论是中医还是西医，遇见失眠患者，很多医

生都喜欢用酸枣仁。有的患者用后有效果，但是绝大多

数患者没有效果。为什么不同患者用酸枣仁后的效果不

一样？答案是致病原因不一样！那么，遣方用药也应

不一样！很多医生用酸枣仁，觉得它是个镇静药，甚

至有人治失眠时炒酸枣仁的用量达到100克，但是照样

不能治失眠。因为酸枣仁不是镇静药，更不能包治各

种失眠。酸枣仁养肝血，肝血能够滋润肝阴。肝在五

行中属于木，木不生火，就不扰心神。心神不乱，人

就安。只要安，人就眠。古人用酸枣仁是养血滋阴柔

肝，防止肝不足而生火的，火旺以后呢，扰动心神。

这是古人用炒酸枣仁治失眠的道理，它是有一定的应

用范围的。假如把酸枣仁作为镇静药来用，500克枣

仁它也不如一瓶安定片镇静作用强，一片安定片才一

分钱，100克酸枣仁多少钱？这是从经济上算，从疗

效上看，不能认为酸枣仁它是个镇静药。中医治失眠

不是以镇静为主。中医治失眠，只有找准病因，求根

治本，才会有“覆杯”之效。

中医辨证治失眠的原理

中医认为，失眠是人体阴阳失衡所导致。但是阴

Outstanding medical experts ｜杏林英才

80 Ⅰ2020/02

临床名医｜Clinic Specialist

阳在中医里面是一个大概念，几乎所有的病都是因为

阴阳失衡所导致。失眠，本质上是人体经脉之气的阴

阳不能相抱。古人认为，阳气入阴气则寐，阳气出于

阴气则悟。我们在治失眠时，就要想法滋阴敛阳，让

阳气进入阴。

中医治失眠要抓住患者失眠的时间段，在什么时

间段失眠，其病因往往是不同的。中医对脏腑有很细

的划分，如有心阴，也有心阳，有肾阴也有肾阳，有

肝阴也有肝阳，患者的失眠症到底是心阴心阳失去平

衡造成，还是肝阴肝阳失去平衡造成，还是脾阳脾阴

失去平衡造成，还是肾阴肾阳失去平衡造成，要从患

者的脉象来确定。

根据不同的情况，医生开出的方和药不一样。中

医是讲究辨证论治，一方一药，一症一药，病无定病，

方无定方，医生永远是根据具体病症来遣方用药。比

如说有一位失眠患者，夜里12点醒后，就再也就睡不

着了，这个时候，时辰属于子时，子胆，胆经是在少

阳，少阳一动，生火，扰乱心神，神乱不安。我们根

据中医的辨证，这个时候是少阳火旺，少阳易动，我

们用柴胡舒肝汤，和解少阳，或者是用小柴胡汤加

减，或者是用四逆散，只要是舒肝和解少阳，再稍加

一些有助睡眠的药，基本上几付药就能解决患者问

题。

失眠的病因，男女不一样，老年、中年也不一

样。一般的女性失眠，多从肝上着手，因为女性大多

数脾虚肝郁，虚久化火，女性一般要舒肝解郁、健脾

安神。男人要从肾上着手，男性一般多是肾虚。而老

人则要益气补血。

张金波指出，有时患者的一句话，就是医生宝贵

的诊断信息。比如说，患者常梦见打仗或是决斗，一

般是肝火旺盛。梦见老是飞腾，一般认为是气盛，梦

见总是从高空处坠落，中医认为是肾虚。总是梦见一

些生活的琐碎小事，就是脾虚了。多思伤脾，就容易

做梦缠绵，并且有时候会出现做梦连续剧，昨天晚上

做的梦，今天晚上还可以接着昨天的继续往下做，这

是思多伤脾，中医认为病因源于“意”，因为“脾主

意”，患者经常思考一些问题，过度思虑。“意”，

就是思考，中医一般用健脾养心，这个时候要用归脾

汤。悲思忧恐惊，不同情志用方是不一样的。男性总

是梦见水，一般是肾出了问题，按照中医断病，可能

是前列腺出了问题，或是膀胱经出了问题。

但是，在治疗失眠方面，药物也不是万能的。药

疗不如食疗，食疗不如心疗。白天想办法让自己精神

饱满，适当运动出汗。一运动一出汗，全身的经脉就

会处于开合的状态，一出汗经脉就运行通畅了，经脉

就会按时出入，阴阳就能按时“相生相抱”。因此，

白天运动出出汗，也是解决睡眠问题的好办法。这不

是药的疗法，这是中医疗法，也叫自然疗法。只要知

道失眠是怎么导致的，找到病根，用什么法都可以

治，法无定法。难道中医治病就一定要用药吗？

张金波简介

男，1964年生，山东中医药大学硕士研究生导师，

北京中医药大学临床特聘专家。他发挥《内经》“诸气膹

郁，皆属于肺”学说，提炼了“宣解通透”的辨证论治思

想；他提出宣解、通透、中正、开阖、启闭治病十法，认

为全身经脉都依仗于三焦，依附于皮毛，肺气怫郁，使玄

府闭塞为主要病机，著有《玄冥用药心法》。他提出“痹

于外，而痿于内，瘕于内，而癥于外”的学术观点，发明

了循经挑刺法，丰富外治法的范围；他宣解通透玄府，佐

金平木治疗肝病；他提出脏腑血管经络及四肢百骸亦有

表，皆有肺所主的新观点，创新了“解表宽中扩络”的新

理论。他在医院国医堂专家门诊坐诊，日门诊平均达70多

人，最多可达100人次以上，慕名求医者来自全国各地，以

及美国、加拿大、日本、韩国等国家的海外华人和国际友

人。在中医院工作的他，门诊挂号、预约的人往往排到凌

晨十二点，甚至有的人在前一天的下午来等号，临床疗效

让他拥有巨大的社会影响力。

2020/02Ⅰ 81

Zhang Jinbo is the director of the "Preventive Treatment" Center of Yantai Hospital of Traditional Chinese

Medicine and a distinguished clinical expert of TCM at Beijing University of Traditional Chinese Medicine. In

addition to patients from all over the country, there are also international friends from the United States, Canada,

Japan, South Korea, etc. This is the huge social impact of the Chinese Medicine Hospital at 12 o'clock in the

morning, even the first afternoon in the outpatient department, equal number, registration, and appointment

registration two months ago. See page for details.

张金波是烟台市中医医院“治未病”中心主任，也是北京中医药大学中医临床特聘专家，慕名求医者来

自全国各地，以及美国、加拿大、日本、韩国等国家的海外华人和国际友人。在中医院工作的他，门诊

挂号、预约的人往往排到凌晨十二点，甚至有的人在前一天的下午来等号，临床疗效让他拥有巨大的社

会影响力。详见79页。

Cao Dongyi believes that when Chinese medicine goes to the world, it must show its individuality and pay equal

attention to Taoism and art, and cannot use laboratory indicators to restrict its development. "Respect orthodoxy and

strive to innovate" is the instruction given to us by General Secretary Xi, and it is also the call of the times. See page

for details .

曹东义认为，中医药走向世界，必须彰显个性，道术并重，而不能用实验室的指标限制自身发展，不能舍本

逐末，西化中医，丢了自己。“守正创新”是习总书记给我们的指示，也是时代的呼唤。详见54页。