从补土理论探析胃肠道肿瘤氟尿嘧啶化疗相关性口腔溃疡的辨治  

Exploring syndrome differentiation and treatment of oral ulcers induced by fluorouracil chemotherapy for gastrointestinal tumors based on the theory of nourishing earth

作　　者：李滢 刘寨东[2] LI Ying;LIU Zhaidong(The First Clinical Medical College of Shandong University of Traditional Chinese Medicine,Ji'nan 250014;Shandong University of Traditional Chinese Medicine Affiliated Hospital)

机构地区：[1]山东中医药大学第一临床医学院,济南250014 [2]山东中医药大学附属医院

出　　处：《现代中医临床》2024年第5期61-64,共4页Modern Chinese Clinical Medicine

基　　金：山东省重点研发计划项目(No.2021CXGC010510);山东省中医药科技项目(No.2020M015)。

摘　　要：氟尿嘧啶类化疗药广泛应用于胃肠道恶性肿瘤的治疗,其辛散、壮热之偏性强烈,耗气伤津。胃肠道肿瘤患者脾胃素虚,兼以癌毒侵凌、药毒耗散,呈现中土衰败之象,采用氟尿嘧啶化疗后出现口腔溃疡,治疗应以虚为纲,补土疗疮。外治以补益脾胃为法,用蜂蜜调和粉剂(海螵蛸、白及、鸡内金、山药)涂敷患处,补土敛疮。补中益气汤为内服基础方,补土建中以长养正气,调畅气机以去除火邪。结合临床验案阐释从补土理论探析胃肠道肿瘤氟尿嘧啶化疗相关性口腔溃疡的辨治。Fluorouracil chemotherapy is widely used in the treatment of gastrointestinal malignancies,characterized by its strong dispersing and heat-fever-inducing properties in TCM terms,which consume qi and damage body fluids.Patients with gastrointestinal tumors often exhibit a weak spleen and stomach due to the invasion of cancerous toxins and the depletion caused by chemotherapy drugs.Consequently,oral ulcers frequently occur following fluorouracil chemotherapy.Treatment should focus on addressing underlying deficiencies and nurturing the earth element.External treatment involves applying a honey-based paste mixed with powdered herbs,such as Haipiaoxiao(Endoconcha Sepiae),Baiji(Rhizoma Bletillae),Jineijing(Endothelium Corneum Gigeriae Galli),and Shanyao(Rhizoma Dioscoreae),to the affected areas to nourish the earth and heal the ulcer.Internally,the treatment utilizes Buzhong Yiqi Decoction(Center-Supplementing and Qi-Boosting Decoction) to invigorate the spleen and stomach,tonify qi,regulate qi movement,and dispel pathogenic heat.This paper discusses the treatment of chemotherapy-induced oral ulcers in gastrointestinal tumors based on the theory of nourishing earth,supported by clinical cases.

关 键 词：补土理论 胃肠道肿瘤 氟尿嘧啶 化学治疗 口腔溃疡 

分 类 号：R273[医药卫生—中西医结合] R276.8[医药卫生—中医肿瘤科]