抗肿瘤治疗不良反应中医病机探讨  

Discussion on Traditional Chinese Medicine Pathogenesis of Toxic and Side Effects of Tumor Treatment

作　　者：姜彧 孙磊涛 阮善明[2] 沈敏鹤[2] JIANG Yu;SUN Leitao;RUAN Shanming(The First Clinical Medical School of Zhejiang Chinese Medical University,Hangzhou(310053),China;The First Affiliated Hospital of Zhejiang Chinese Medical University;Academy of Chinese Medical Science,Zhejiang Chinese Medical University)

机构地区：[1]浙江中医药大学第一临床医学院,杭州310053 [2]浙江中医药大学附属第一医院 [3]浙江中医药大学中医药科学院

出　　处：《浙江中医药大学学报》2023年第5期540-543,共4页Journal of Zhejiang Chinese Medical University

基　　金：2023年度浙江省中医药科技计划项目(2023ZR095);中国博士后科学基金资助项目(2021M702928);中华中医药学会青年人才托举工程(2021-QNRC2-B13)。

摘　　要：[目的]从中医理论的角度阐述现代抗肿瘤治疗不良反应的不同病机,以期寻找应对法则。[方法]分析恶性肿瘤化疗、放疗、免疫、靶向治疗后出现的不良反应,分析临床病理表现,推导中医病机。[结果]通过对临床症状及治疗方式进行总结,得出化疗药毒引起黏膜损伤、骨髓抑制、手足麻木等症状,多从气血生化不足论治;免疫、靶向药毒具有风热属性,激发阳亢,皮疹、乏力症状常见;放疗伤津口渴,损络出血,与火毒损伤气阴相关。[结论]不同类型的抗肿瘤治疗方式存在不同的损伤机制,这也启发了临床中对多种抗肿瘤不良反应的治疗法则,针对不同特性,化疗前后重气血培补,免疫、靶向治疗谨守阴平阳秘之要,放疗后以益气养阴清热为主,为临床抗肿瘤治疗提供中医辅助诊疗的临床思路。[Objective]To explicate modern antitumor adverse effects from traditional Chinese medicine(TCM)pathogenesis with a view to find coping laws.[Methods]The adverse effects of malignant cancer treatment in chemotherapy,radiotherapy,immunity and targeted therapy were analyzed,and the characteristic pathological manifestations were centrally analyzed to derive the TCM pathogenesis.[Results]Based on the clinical symptoms,it was concluded that the symptoms such as mucosal damage,bone marrow suppression,and numbness of hands and feet caused by the toxicity of chemotherapeutic agents were mostly treated from the generation and transportation deficiency of Qi and blood;immunity and targeted drug toxicity have the property of wind and fever,provoking hyperactivity Yang,and the symptoms of rash and fatigue are common;radiation therapy injures body fluids causing thirst,and damaging blood vessels causing bleeding associated with fire injury Qi and Yin.[Conclusion]Different pathogenesis of injury exist in different types of antitumor treatment modalities,which also enlighten the treatment principle of multiple antitumor adverse reactions in the clinic,aiming at different properties,an emphasis is placed on the balance of Qi and blood;immune and targeted treatment are taken to conserve Yin and Yang;after radiotherapy,it increases the Qi and Yin,removes the residual heat mainly,so as to provide clinical ideas for the auxiliary diagnosis and treatment of TCM for clinical antitumor treatment.

关 键 词：恶性肿瘤 不良反应 中医 病机 辨证施治 综合治疗 

分 类 号：R271[医药卫生—中医妇科学]