从“毒致血枯”理论探讨结直肠癌伴贫血的辨治思路  

Discussion on the differentiation and treatment of anemia in colorectal cancer based on"toxicity-induced blood depletion"

作　　者：李芮 张彤[1] 吴娜 杨宇飞[1] LI Rui;ZHANG Tong;WU Na;YANG Yufei(Xiyuan Hospital,China Academy of Chinese Medical Sciences,Beijing 100091)

机构地区：[1]中国中医科学院西苑医院,北京100091

出　　处：《现代中医临床》2024年第2期65-68,共4页Modern Chinese Clinical Medicine

基　　金：首都卫生发展科研专项(No.2022-1-41-71)。

摘　　要：贫血是结直肠癌(CRC)最常见的并发症之一。中医认为内生“癌毒”是肿瘤发生的重要原因,CRC伴贫血发病机制与“癌毒”密切相关。CRC伴贫血是由于机体本身先后天失养,癌毒及药毒阻于脏腑、碍于脾肾两脏,导致髓竭血枯之症。“毒致血枯”是CRC伴贫血的基本病机,包括:癌毒流窜、脾气亏虚和药毒流窜、脾肾两虚。扶正祛邪、健脾益肾为CRC伴贫血治疗大法。CRC伴贫血未治疗期,“癌毒”独占体内、流窜脏腑致虚为贫血之因,重在祛瘀解毒、健脾益气。CRC伴贫血化疗期,“药毒”峻猛损伤气血,使虚者更虚,最终精血衰败,重在健脾益肾、助髓生血。Anemia emerges as a prevalent complication in colorectal cancer(CRC),and Traditional Chinese Medicine(TCM)attributes its occurrence to the intrinsic generation of"cancer toxin",a pivotal factor in tumor development.The mechanism of anemia in CRC is intricately linked to the dynamics of"cancer toxin".The onset of anemia in CRC results from a combination of inherent deficiencies,obstruction by cancer toxins and drug toxicity affecting the visceral organs,particularly hindering the functions of the spleen and kidneys,leading to a state of marrow exhaustion and blood depletion.The fundamental pathogenic process,termed"toxicity-induced blood depletion",encompasses the infiltration of cancer toxins,deficiency in spleen qi,and the wandering toxicity of chemotherapy drugs in tandem with the weakness of the spleen and kidneys.The primary therapeutic strategy for addressing anemia in CRC involves tonifying the body's righteous qi,dispelling pathogenic factors,and nourishing the spleen and kidneys.During the untreated phase of CRC with anemia,the dominance and spread of"cancer toxin"throughout the body contribute significantly to the anemic condition.The focus lies on eliminating stasis,removing toxins,and invigorating the spleen to replenish qi.In the chemotherapy phase,the potent impact of chemotherapy drugs further diminishes the qi and blood,exacerbating the existing deficiencies.The emphasis shifts to strengthening the spleen,nourishing the kidneys,and assisting in the generation of marrow and blood.

关 键 词：结直肠癌伴贫血 癌毒 毒致血枯 中医治疗 理论探讨 

分 类 号：R259[医药卫生—中西医结合]