徐荷芬教授治疗化疗性恶心呕吐经验  

Professor XU Hefen’s experience in the treatment of chemotherapy-induced nausea and vomiting

作　　者：王馨 左武琪 WANG Xin

机构地区：[1]江苏大学附属金坛医院,江苏常州213200 [2]江苏省中医院溧阳分院,江苏常州213300

出　　处：《中医临床研究》2023年第31期145-148,共4页Clinical Journal Of Chinese Medicine

基　　金：江苏省中医院溧阳分院院内人才培养工程(溧阳发[2020]62号)。

摘　　要：西医化疗是治疗恶性肿瘤核心方式之一,而化疗引起的恶心和呕吐是其常见的不良反应,严重影响患者的生活质量。目前,西医在防治化疗引起的恶心和呕吐方面效果稳定,起效迅速,但对延迟性恶心和呕吐的止吐效果不佳,并且常常引起腹胀、便秘等不良反应。相较而言,中医治疗化疗引起的恶心和呕吐具有手段多样、使用简便、疗效显著等优势。江苏省首届国医名师、全国名老中医学术经验继承工作指导老师徐荷芬教授从事中西医结合治疗肿瘤的科研与临床工作60余载,对肿瘤的中医药综合治疗有着丰富经验。徐老认为,肿瘤患者经化疗后脾气亏虚,化生不足,气血生化乏源,以致气血津液俱损,是其重要的发病基础。病性为本虚标实,病位主在中焦。临证主要分为脾胃虚寒、胃失和降证;阴虚胃热、气逆不降证;脾失运化、痰湿内阻证;寒热错杂、升降失司证4个证型。在治则上,徐老提出以“补虚和胃降逆”配合“解毒散结抗癌”为大法。临床常用和胃降逆的药串有二:炒白术、枳实、竹茹、生姜;柿蒂、姜半夏、陈皮、白豆蔻。辨治经验有3个要点:培土生元,以“阴”为要;内外同治,良效双收;心理干预,积极引导。文章结合案例,介绍徐荷芬教授治疗化疗性恶心呕吐的学术思想和个人经验,以期为临床提供参考。Western medicine chemotherapy is one of the core methods for treating malignant tumors,and chemotherapy induced nausea and vomiting(CINV)is a common adverse reaction that seriously affects the quality of patients life.At present,Western medicine has a stable and rapid effect on CINV,but it has poor antiemetic effects on delayed CINV and often causes adverse reactions such as abdominal distension and constipation.Traditional Chinese medicine has advantages over Western medicine in treating CINV,such as diverse methods,simple use and significant therapeutic effects.Professor XU Hefen,the first famous teacher of national medicine in Jiangsu Province,has been engaged in the scientific research and clinical work of integrated medicine in the treatment of tumors for more than 60 years,and has rich experience in the comprehensive treatment of tumors with traditional Chinese medicine.Professor XU believes that the deficiency of spleen Qi(气)in tumor patients after chemotherapy is an important cause of disease.The nature of the disease is deficiency in origin and excess in superficiality,and the location of the disease is mainly in the middle energizer.In terms of treatment,Professor XU proposed tonifying deficiency,harmonizing stomach and reducing adverse reactions combined with detoxification,dispersing nodules and anti-cancer as the main method.There are two kinds of medicine strings commonly used in clinic:Fried Baizhu(Rhizoma Atractylodis Macrocephalae),Zhishi(Fructus Aurantii Immaturus),Zhuru(Caulis Bambusae in Taenia),Shengjiang(Rhizoma Zingiberis Recens).Shidi(Calyx Kaki),Jiangbanxia(Rhizoma Pinelliae),Chenpi(Pericarpium Citri Reticulatae),Baidoukou(Fructus Amomi Rotundus).There are 3 key points of discernment experience:cultivate soil biotics,and take Yin(阴)as the key.Internal and external treatment with good results and double income.Psychological intervention and positive guidance.This paper introduces professor XU Hefen’s academic thoughts and personal experience in the treatment of chemotherapy-induced n

关 键 词：化疗 恶心呕吐 中医外治法 名医经验 

分 类 号：R249[医药卫生—中医临床基础]