基于性味归经理论浅谈安罗替尼的中药药性  

A study on the medicinal properties of anlotinib based on the theory of property,taste and channel-tropism

作　　者：伍卓珺 文枝 王理槐[2] 赖桂花 向婷婷[1] 王菲[1] 曹建雄[2] WU Zhuojun;WEN Zhi;WANG Lihuai;LAI Guihua;XIANG Tingting;WANG Fei;CAO Jianxiong

机构地区：[1]湖南中医药大学,湖南长沙410000 [2]湖南中医药大学第一附属医院,湖南长沙410000

出　　处：《中医临床研究》2023年第6期105-107,共3页Clinical Journal Of Chinese Medicine

基　　金：湖南省自然科学基金(2021JJ30525)。

摘　　要：目前肿瘤的治疗已经进入了个体化的“精准医疗”时代,通过对基因状态及细胞程序性死亡-配体1等指标的检测可以制订更加高效、低毒的治疗方案,但对于无精准靶向药物可用的患者而言,常用的治疗方案如放化疗、抗血管生成等仍缺少一定的指向性,因此若能将性味归经理论引进到肿瘤治疗的理念中,用以评估药物治疗可能的适宜人群,在一定程度上可以提高用药的准确性,并降低不良反应的发生率。中医性味归经理论以阴阳五行理论为基础,根据机体用药反应,通过逻辑推理,探讨药物的四气五味、升降浮沉及归经,用以指导临床应用。将性味归经理论引进到肿瘤治疗的理念中,对提高肿瘤治疗的指向性和力度、减低不良反应具有一定的意义。文章以血管靶向药物安罗替尼为例进行分析,安罗替尼属于抗血管生成类药物,主要应用于肺癌、软组织肉瘤、甲状腺癌等疾病,根据其作用机制、不良反应、临床实践,推测其四气为热,五味属辛、咸,升降浮沉中具有双向性,主要归心、脾二经。因此临床运用安罗替尼时,若中医辨为心脾热盛、血热吐衄等实热证或气阴亏虚等虚热证,应注意配伍养阴生津类药物。Currently,the treatment of tumor has entered the era of individualized“precision medicine”.Through the detection of gene status and PD-L1 and other indicators,more efficient and less toxic treatment programs can be developed.However,for patients with no precise targeted drugs available,the commonly used treatment programs such as radiotherapy and chemotherapy,anti-angiogenesis,etc.,still lack certain direction.Therefore,if the theory of property,taste and channel-tropism can be introduced into the concept of tumor treatment to evaluate the possible suitable population of drugs,the accuracy of drug use can be improved to a certain extent and the incidence of adverse reactions can be reduced.TCM theory of property,taste and channel-tropism is based on the theory of Yin(阴)and Yang(阳)and the five elements.According to the drug reaction of the body,the four properties and five tastes,the rise and fall and channel-tropism are discussed through logical reasoning,so as to guide the clinical application.Introducing the theory of property,taste and channel-tropism into the concept of tumor treatment has certain significance for improving the directivity and intensity of tumor treatment and reducing adverse reactions.In this paper,the vascular targeting drug anlotinib is taken as an example for analysis.Anrotinib belongs to the class of antiangiogenic drugs,which is mainly used in lung cancer,soft tissue sarcoma,thyroid cancer and other diseases.According to its mechanism of action,adverse reactions,and clinical practice,it is presumed that the four property of anlotinib is heat,the five tastes are spicy and salty,and the rise and fall of anlotinib are bidirectional.Therefore,in the clinical use of anlotinib,if traditional Chinese medicine can distinguish the hyperheat syndrome such as heart-spleen heat and blood-heat epistaxis or the deficiency heat syndrome such as Qi and Yin deficiency,attention should be paid to the combination use of nourishing Yin and blood drugs.

关 键 词：安罗替尼 四气 五味 升降浮沉 归经 

分 类 号：R285.1[医药卫生—中药学]