中医辨病、辨证、辨症治疗表皮生长因子受体抑制剂相关皮疹的回顾与思考  

Review and thinking on the treatment of epidermal growth factor receptor inhibitor related skin rash by differentiation of diseases,syndrome,symptom in traditional Chinese Medicine

作　　者：刘戴维 崔慧娟 李占林[1] 樊捷婷 耿艳琴 范怿洁 冯冬梅 LIU daiwei;CUI huijuan;LI zhanlin;FAN jieting;GENG yanqin;FAN yijie;FENG dongmei(The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院中医科,张家口075000 [2]河北北方学院附属第一医院皮肤科,张家口075000 [3]中日友好医院中西医结合肿瘤内科

出　　处：《环球中医药》2021年第7期1358-1362,共5页Global Traditional Chinese Medicine

基　　金：国家自然科学基金(81873396);河北省中医药管理局项目(2021186);首都卫生发展科研专项(首发2018-2-4065)。

摘　　要：表皮生长因子受体抑制剂(epidermal growth factor receptor inhibitors, EGFRIs)相关皮肤不良反应,主因肺癌患者素体禀赋不足,复感药毒、风、热、湿邪而致。本病脏腑病位在肺胃,属本虚标实,应以扶正祛邪为治则。部分医家从疾病分期结合中医辨证进行探讨,有的医家从卫气营血角度辨证,有的从六淫辨证角度辨治,主要将本病分为风热证、湿热证、血热证、阴虚证四种证型论治。瘙痒症状和干燥脱屑症状,严重影响EGFRIs相关皮疹患者生活质量。因此,临证治疗时,需注重辨证与辨症相结合。The main cause of Epidermal Growth Factor Receptor Inhibitors(EGFRIs)related skin rash is deficiency of natural endowment with drug poisoning,wind,heat and dampness.This disease location is in the lung and stomach,and it belongs to deficiency in root and excess in superficiality.Strengthening the body and dispelling pathogenic factors should be taken as the rule of treatment.Some doctors discuss the treatments by stages combining with TCM Syndrome differentiation.Some doctors treat it from the perspective of defence-qi-nutrient-blood pattern identification,others treat it from the perspective of Six Yin Syndrome differentiation,the disease can be differentiated into wind-heat Syndrome,damp-heat Syndrome,blood-heat syndrome and Yin Deficiency Syndrome.The quality of life in patients with EGFRIs-associated Rashes was significantly affected by pruritus and dry scaling.Therefore,in clinical treatment,both syndrome differentiation and symptom differentiation should be attached importance to and combined.

关 键 词：肺癌 表皮生长因子受体抑制剂相关皮疹 本虚标实 辨病论治 辨证论治 辨症论治 分期论治 

分 类 号：R275.9[医药卫生—中西医结合]