老年高危骨髓增生异常综合征的辨治思路和方法  

Thoughts and methods of differentiation and treatment of senile high-risk myelodysplastic syndrome

作　　者：靳楠 毛悦 唐旭东[2] JIN Nan;MAO Yue;TANG Xudong(Beijing University of Chinese Medicine,Beijing 100029;Department of Hematology,Xiyuan Hospital,China Academy of Chinese Medical Sciences)

机构地区：[1]北京中医药大学,北京100029 [2]中国中医科学院西苑医院血液科

出　　处：《现代中医临床》2022年第5期35-38,共4页Modern Chinese Clinical Medicine

基　　金：国家自然科学基金面上项目(No.81673819,No.82074258);中国中医科学院科技创新工程重大攻关项目(No.CI2021A01701)。

摘　　要：骨髓增生异常综合征(MDS)是获得性造血干细胞的恶性克隆性疾病。根据老年高危MDS的症状,将其归属于中医“髓毒劳”范畴。其病因病机以脾肾两虚为本,瘀血等多种致病因素共同作用。临床辨证施治原则:解毒化瘀为宗,补益脾肾为本;同时重视调补脾胃,疏肝理气;治法上寒热共用,阴阳平调。结合临床医案对老年高危MDS的诊治经验进行总结。Myelodysplastic syndrome(MDS) is a malignant clonal disease of acquired hematopoietic stem cells. According to the symptoms of high-risk MDS in the elderly, it belongs to the category of suǐ dú láo(marrow poisoning and fatigue) in traditional Chinese medicine. Its etiology and pathogenesis are based on deficiency of the spleen and kidney, coupled with blood stasis and other pathogenic factors. Clinical principle of syndrome differentiation and treatment: detoxification and removing blood stasis as the core, tonifying spleen and kidney as the foundation;the approach of regulating and tonifying the spleen and stomach, and soothing liver and regulating qi is also emphasized. The combined use of cold and heat medicinals is key in the treatment, and special attention is given to maintaining the yin and yang balance. This paper summarizes the experience of diagnosis and treatment of elderly high-risk MDS based on clinical case records.

关 键 词：骨髓增生异常综合征 髓毒劳 补肾健脾 青黄散 

分 类 号：R259[医药卫生—中西医结合]