基于“升阳益胃法”探析阑尾黏液性肿瘤的论治思路
Based on the “Shengyang Yiwei Method” to Explore the Treatment Strategy for Appendiceal Mucinous Neoplasms

阑尾黏液性肿瘤(AMNs)是临床罕见病，属中医“肠痈”“癥瘕”等范畴，临床表现可见腹胀、腹痛、腹泻。本文基于施丽婕主任医师临床经验，发挥李东垣“升阳益胃法”理论，系统探讨该病的中医辨治思路。研究认为，AMNs的核心病机在于中焦脾胃正气亏虚，气机升降失常，导致痰、湿、瘀、毒互结，形成虚实夹杂之证。施丽婕主任医师提出“固本、调衡、消壅”的临证策略，固本以健脾益气为主，调衡重在恢复脾胃升降之机，消壅则针对痰瘀毒结予以化解，三者相辅相成，共同构成AMNs的中医治疗框架。文中附验案一则，以升阳益胃汤为基础进行辨证加减，可有效改善患者临床症状，体现了理法方药的一致性，为中医参与该罕见病的诊疗提供了理论依据与实践参考。
Appendiceal Mucinous Neoplasms (AMNs) are a clinically rare disease, categorized in Traditional Chinese Medicine under “intestinal abscess” or “abdominal mass”, with clinical manifestations including abdominal distension, pain, and diarrhea. Based on the clinical experience of Chief Physician Shi Lijie, this paper elaborates on Li Dongyuan’s theory of the “Shengyang Yiwei Method” to systematically explore the TCM diagnosis and treatment approach for this condition. The study posits that the core pathogenesis of AMNs lies in the deficiency of healthy qi in the middle jiao (spleen and stomach) and the disruption of qi movement, leading to the intermingling of phlegm, dampness, stasis, and toxins, resulting in a complex condition characterized by both deficiency and excess. Chief Physician Shi Lijie proposes a clinical strategy of “consolidating the root, regulating balance, and resolving stagnation”. Consolidating the root focuses on strengthening the spleen and replenishing qi, regulating balance emphasizes restoring the ascending and descending functions of the spleen and stomach, and resolving stagnation targets the accumulation of phlegm, stasis, and toxins. These three aspects complement each other, collectively forming the TCM treatment framework for AMNs. A clinical case is included in the paper, demonstrating that modifications based on the Shengyang Yiwei Decoction can effectively alleviate patients’ symptoms, reflecting the consistency of theory, methodology, and prescription. This provides theoretical foundation and practical reference for TCM’s role in diagnosing and treating this rare disease.