对化疗诱导心脏毒性的中医学认识与辨治探讨  

Discussion on Traditional Chinese Medicine Recognition and Dialectical Treatment of Cardiotoxicity Induced by Chemotherapy

作　　者：刘杰 罗莉 余婷 唐东昕 LIU Jie;LUO Li;YU Ting;TANG Dongxin(Guizhou University of Traditional Chinese Medicine,Guiyang 550002,China;Guihang Guiyang Hospital,Guiyang 550006,China)

机构地区：[1]贵州中医药大学,贵州贵阳550002 [2]贵航贵阳医院,贵州贵阳550006

出　　处：《山东中医杂志》2020年第12期1291-1294,共4页Shandong Journal of Traditional Chinese Medicine

基　　金：贵州省研究生导师工作室(批文号:黔教研合GZS字〔2016〕08);贵州省中医肿瘤传承与科技创新人才基地(批文号:黔人领发〔2018〕3号);贵州省高层次创新型人才培养计划(批文号:黔科合人才(2016)4032号);贵州省研究生工作站计划(批文号:黔教研合JYSZ字〔2014〕018);贵州省科技计划(批文号:黔科合SY字〔2013〕3026号)。

摘　　要：基于化疗诱导心脏毒性研究的现有文献报道和本病临床特点,化疗诱导心脏毒性归属于中医学心悸、胸痹、喘证、痰饮、心水等范畴。病因学认为其来源于药毒;病机概括为药毒内侵,阴阳失和;病位非独在心,而是五脏共同参与;病性以虚为主;病理过程分急性和慢性,急性者,毒重而大伤正气;慢性者,渐积缓伤而正气渐亏。心脏毒性的治疗,一方面基于辨证与辨病相结合,参考现代药理学研究成果,于化疗前及与化疗同步进行药物干预,可以选用参芪扶正注射液、参麦注射液等益气类中药制剂;另一方面基于辨证论治,适当参考名家临证经验,以中药复方调节阴阳。According to the existing literature and the clinical characteristics,chemotherapy-induced cardiotoxicity belongs to the category of palpitation,chest obstruction,asthma syndrome,phlegm and water in the heart in traditional Chinese medicine.Etiology holds that it comes from drug toxicity,and the pathogenesis can be summarized as drug toxicity invasion and yin and yang disharmony.The location of the disease is not merely in the heart,but in the five viscera.The disease is mainly due to deficiency and the pathological process is divided into acute stage and chronic stage.In acute cases,the drug toxicity is heavy,which can seriously injure the healthy qi.In chronic cases,the injury is gradually accumulated and the healthy qi is gradually lost.For the treatment of cardiotoxicity,on the one hand,based on the combination of syndrome differentiation and disease differentiation,and referring to the research results of modern pharmacology,we can choose Shenqi Fuzheng Injection(参芪扶正注射液),Shenmai Injection(参麦注射液)and other traditional Chinese medicine preparations for tonifying qi before and during chemotherapy.On the other hand,based on syndrome differentiation and treatment,and properly referring to the clinical experience of famous experts,traditional Chinese medicine compound prescription can be used to regulate the whole yin and yang.

关 键 词：心脏毒性 化疗 不良反应 中医病因学 辨证论治 未病先防 调节阴阳 癌症 

分 类 号：R256.2[医药卫生—中医内科学]