基于骨骼肌代谢探讨从“脾肾”“气血”论治癌性恶液质  

Exploring Cancer Cachexia Treatment Based on Skeletal Muscle Metabolism from the Perspective of“Spleen-Kidney”and“Qi-Blood”Theory

作　　者：张旭[1] 杨国旺[1] 佟丽[1] ZHANG Xu;YANG Guowang;TONG Li(Beijing Hospital of Traditional Chinese Medicine Affiliated to the Capital Medical University,Beijing 100010,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010

出　　处：《中医药学报》2024年第12期6-10,共5页Acta Chinese Medicine and Pharmacology

基　　金：国家自然科学基金面上项目(82174453);北京中医医院职工创新工作室创新项目(ZT202108);北京中医医院院级课题暨两院合作课题(LYYB202217);北京市属医院科研培育计划项目(PZ2024029)。

摘　　要：肿瘤患者恶液质发生率较高,而骨骼肌蛋白大量降解导致骨骼肌萎缩是肿瘤患者发生恶液质的特征病理改变。癌性恶液质归属于中医“虚劳”范畴,脾肾两亏、气血不足是其发病基础,湿、痰、瘀、毒是其主要病理因素。脾失健运则气血生化乏源,患者呈现“负氮平衡”,加速骨骼肌的分解代谢;肾气亏虚则机能受损,患者活动能力受限可导致肌肉逐渐萎废。中医药在改善癌性恶液质骨骼肌代谢方面显示出独特的优势,治疗多从“健脾补肾、益气养血”入手,同时根据病情酌情运用祛湿、化痰、逐瘀、解毒散结等法兼以祛邪,以达到标本同治的效果,使气血得以充盈,肌肉得以荣养。Cancer cachexia is common among tumor patients,characterized by significant skeletal muscle protein degradation and muscle wasting.Cancer cachexia belongs to the scope of Traditional Chinese Medicine(TCM)“deficiency fatigue,”with spleen and kidney deficiency and qi-blood insufficiency as the pathological basis,and dampness,phlegm,stasis,and toxins as the main pathological factors.Spleen deficiency leads to insufficient qi and blood production,resulting in a“negative nitrogen balance”and accelerated skeletal muscle breakdown metabolism.Kidney qi deficiency impairs function,limiting the patient s mobility and gradually leading to muscle wasting.TCM has shown unique advantages in improving cancer cachexia skeletal muscle metabolism,focusing in treatment on“strengthening the spleen and tonifying the kidneys,replenishing qi,and nourishing blood.”Additionally,treatments such as dampness elimination,phlegm resolution,stasis removal,detoxification,and binds dispersion are applied as needed to expel pathogens and achieve the dual purpose of addressing both the root cause and symptoms,thereby replenishing qi and blood and nurturing the muscles.

关 键 词：癌性恶液质 骨骼肌代谢 脾肾 气血 

分 类 号：R255.5[医药卫生—中医内科学]