国医大师王晞星辨治肺腺癌靶向相关性药疹经验采菁  

Wang Xixing's experience in the treatment of drug eruptions related to targeted drugs for pulmonary adenocarcinoma

作　　者：石智尧 孙佩飞 高宇[2] 刘佳佳 王晞星[2] SHI Zhiyao;SUN Peifei;GAO Yu;LIU Jiajia;WANG Xixing(Shanxi University of Chinese Medicine,Taiyuan 030024,China;Shanxi Institute of Traditional Chinese Medicine,Taiyuan 030012,China)

机构地区：[1]山西中医药大学,太原030024 [2]山西省中医药研究院,太原030012

出　　处：《吉林中医药》2024年第6期657-660,共4页Jilin Journal of Chinese Medicine

基　　金：第四届国医大师传承工作室(国中医药办人教函[2022]245号);国家中医药传承创新中心的建设队项(202203);山西省中医临床医学研究中心(培育)项目(晋科社发[2019]61号);山西省卫健委山西省医学科技创新团队项目(2020TD04);山西省卫健委山西省医学重大科技攻关专项(2022XM10)。

摘　　要：王晞星教授认为少阳枢机不利,风湿热毒之邪侵袭为靶向药酪氨酸酶抑制剂所致药疹之核心病机。治法上强调以“和解”为本,通过和枢机、解郁结、清热利湿解毒之法治疗本病,并在此基础上创制柴胡土茯苓合剂方。临床中若治疗得当,病邪可从少阳经外出入太阳表经;若失治误治,病邪可内传少阴出现少阴热化证。强调应重视疾病所处病机阶段,准确辨证,方能取得佳效。Professor Wang Xixing believes that the blocked Shaoyang qi movement and the pathogen invasion of wind-dampness-heat-toxicity constitute the core pathogenesis of drug eruptions caused by targeted tyrosine kinase inhibitors(TKI).He underscores that its treatment should be based on the application of the harmonizing and detoxifying methods,treating the disease by harmonizing the function of Shaoyang,relieving qi stagnation,clearing heat and promoting diuresis for detoxification.And on that basis,he creates the Chaihu Tu Fuling combination formula.In his view,the pathogens may exit out of the Shaoyang meridians and enter into the Taiyang epidermal meridians if the disease is treated properly in clinical practice,while they can also be transmitted internally to the Shaoyin meridians,manifested as a heat transformation syndrome of Shaoyin if it is left untreated or mistreated.It is emphasized that attention should be paid to the pathogenesis stages of the disease and the accurate identification of syndromes to achieve a good curative effect.

关 键 词：肺腺癌 酪氨酸酶抑制剂 靶向相关性药疹 和解解毒 王晞星 

分 类 号：R256.1[医药卫生—中医内科学]