从玄府理论探讨中医针药结合治疗化疗所致周围神经病变  

Discussion on Treatment of Chemotherapy-induced Peripheral Neuropathy with Combination of Acupuncture and Medicinal in Traditional Chinese Medicine Based on Xuanfu Theory

作　　者：刘欣琦 何鋆怡 冯利 田爱平 殷玉琨 江正龙 刘丽星 胡薪蕊 杜宁 LIU Xin-qi;HE Jun-yi;FENG Li;TIAN Ai-ping;YIN Yu-kun;JIANG Zheng-long;LIU Li-xing;HU Xin-rui;DU Ning(National Cancer Center/National Cancer Clinical Medical Research Center/Department of Traditional Chinese Medicine,Cancer Hospital,Chinese Academy of Medical Sciences,Hebei,Langfang 065001)

机构地区：[1]国家癌症中心/国家肿瘤临床医学研究中心/河北中国医学科学院肿瘤医院中医科,廊坊065001 [2]北京中医药大学东直门医院,北京100700 [3]国家癌症中心/国家肿瘤临床医学研究中心/中国医学科学院北京协和医学院肿瘤医院中医科,北京100021

出　　处：《河北中医药学报》2023年第2期10-14,共5页Journal of Hebei Traditional Chinese Medicine and Pharmacology

基　　金：北京市自然科学基金委员会面上项目:No.7222293;中华中医药学会研究与评价专项课题:No.CACMRE2021-A-05;中国医学科学院中央级公益性科研院所基本科研业务费专项资金项目:No.2019XK320072;北京协和医学院学科建设项目:No.201920100302;北京融合医学发展基金会资助项目:No.RH-2033-JF23。

摘　　要：“玄府”首载于《黄帝内经》,经刘完素等医家传承与创新逐步发展成具有中医原创性的理论体系,其在认识疾病与指导治疗上具有重要意义。化疗所致周围神经病变(CIPN)是一种病位在皮部的化疗常见的不良反应,其病因病机与玄府理论密切相关。本文从玄府理论与CIPN的关系出发,认为CIPN的病机主要为“玄府开阖失司”,治疗上应联合应用中药内服与针刺外治,从温经开玄、祛瘀通玄、补虚固玄辨证施治,达到恢复玄府正常开阖的目的。基于玄府理论指导临床应用内治法与外治法相结合的中医治疗,为诊治CIPN提供思路。Xuanfu(sweat pore)was first recorded in the Huangdi Neijing(The Yellow Emperor’s Inner Classic),and gradually developed into a theoretical system with original Chinese medicine through inheritance and innovation by physicians such as Liu Wansu.It has important significance in understanding diseases and guiding treatment.Chemotherapy-induced peripheral neuropathy(CIPN)is a common adverse reaction of chemotherapy located in the skin.Its etiology and pathogenesis are closely related to the Xuanfu theory.Based on the relationship between Xuanfu theory and CIPN,this article believes that the main pathogenesis of CIPN is"opening and closing of sweat pores are out of control".Treatment should be combined with internal administration of Chinese medicine and external acupuncture,from syndrome differentiation of warming meridians and opening sweat pores,clearing blood stasis and unblocking the pores,and reinforcing deficiency and consolidating the pores,in order to restore the normal opening and closing of Xuanfu.Xuanfu theory is used to guide clinical application of TCM treatment combining internal and external therapies,providing ideas for the diagnosis and treatment of CIPN.

关 键 词：玄府理论 化疗所致周围神经病变 痹证 不仁 针药结合 内外治法结合 玄府开阖 

分 类 号：R255.6[医药卫生—中医内科学]