参芪地黄汤治疗安罗替尼相关蛋白尿经验浅析  

An analysis of Shenqi Dihuang decoction in treating proteinuria associated with anlotinib

作　　者：徐秦娟 廖天天 胡敏[1] 祝朝富 XU Qinjuan;LIAO Tiantian;HU Min;ZHU Chaofu

机构地区：[1]成都中医药大学附属医院,四川成都610075

出　　处：《中医临床研究》2024年第15期123-126,共4页Clinical Journal Of Chinese Medicine

基　　金：四川省自然科学项目(2022NSFSC0748)。

摘　　要：祝朝富教授从事肿瘤中西医结合诊疗工作多年,对各类肿瘤手术、放疗、化疗、靶向等治疗手段所致不良反应具有丰富的中医药处理经验。盐酸安罗替尼是我国自主研发的一种小分子多靶点酪氨酸激酶抑制药,口服给药、安全性较高、便于携带等特点使得它逐渐应用于临床,但众多的不良反应也不能被忽视,我科既往口服安罗替尼靶向治疗肿瘤患者中出现的最明显不良反应为蛋白尿,运用西药治疗安罗替尼相关蛋白尿的方法较少,且临床获益有限。文章将祝朝富教授临证治疗安罗替尼相关蛋白尿特色方药及经验进行归纳总结。但安罗替尼作为三线靶向抗肿瘤药物,使用患者例数有限,不能很好地评估有效率;其次随访以门诊随访为主,开具中药患者自煎、个体化差异较大等因素也影响药物疗效,因此后期会继续深入、细化研究。Professor ZHU Chaofu has been engaged in the diagnosis and treatment of tumor in integrated TCM and Western medicine for many years,and has rich experience in the treatment of adverse reactions caused by various tumor surgery,radiotherapy,chemotherapy,targeting and other therapeutic means.Anlotinib hydrochloride is a small molecule multi-target tyrosine kinase inhibitor independently developed in our country,which has the characteristics of oral administration,high safety and easy portability,making it gradually applied in clinical practice,but numerous adverse reactions can not be ignored.In our department,proteinuria was the most obvious adverse reaction in oral anlotinib targeted therapy for tumor patients in the past.There are few methods to treat proteinuria associated with anlotion in Western medicine,and the clinical benefit is limited.Giving full play to the advantages of traditional Chinese medicine,Professor ZHU Zhaofu concludes that anrotinib-related proteinuria is closely related to the spleen and kidney by summarizing past experience and analyzing the symptoms of the patients,and the syndrome differentiation is deficiency of both Qi(气)and Yin(阴).In clinical practice,classic prescription Shenqi Dihuang decoction(参芪地黄汤)is used to relieve the symptoms and treat them according to syndrome differentiation,and good curative effect has been achieved.This article summarizes the characteristic prescription and experience of Professor ZHU Chaofu in the treatment of anlotinib-related proteinuria based on clinical syndrome differentiation.However,as a third-line targeted anti-tumor drug,anlotinib has a limited number of patients and cannot be evaluated effectively.Secondly,the follow-up is mainly outpatient follow-up,patients decoct the prescribed traditional Chinese medicine themselves,there are large differences in individuation,and other factors also affect the drug efficacy,so in-depth and detailed research will continue in the later stage.

关 键 词：盐酸安罗替尼 蛋白尿 中医临床经验 参芪地黄汤 

分 类 号：R256.5[医药卫生—中医内科学]