解毒养阴法治疗表皮生长因子受体-酪氨酸激酶抑制剂相关性皮疹的临证体悟  

Clinical understanding of the detoxification and nourishing Yin therapy in treating EGFRTKIs related rash

作　　者：赵怡然 王泽文 黄文杰 安红如 王振强[5] ZHAO Yiran;WANG Zewen;HUANG Wenjie;AN Hongru;WANG Zhenqiang

机构地区：[1]河北大学,河北保定071002 [2]承德医学院,河北承德067000 [3]河北中医药大学,河北石家庄050200 [4]华北理工大学,河北唐山063210 [5]河北省沧州中西医结合医院,河北沧州061001

出　　处：《中医临床研究》2024年第24期62-64,共3页Clinical Journal Of Chinese Medicine

摘　　要：靶向药物可以与致癌基因位点特异性结合,诱导癌细胞特异性死亡。当前,表皮生长因子受体-酪氨酸激酶抑制剂(Epidermal Growth Factor Receptor-Tyrosine Kinase Inhibitors,EGFR-TKIs)靶向药物已广泛应用于EGFR突变阳性的非小细胞肺癌(Non-small Cell Lung Cancer,NSCLC)的治疗,但此类药物引起的不良反应对患者生活质量和疗效的影响也不容忽视。皮疹是EGFR-TKIs治疗过程中最常见、最典型的不良反应之一,属于中医“药毒”“药毒疹”范畴,其对患者生活质量的影响可能导致治疗中断甚或终止。中医药与靶向药物治疗联合可以起到减毒增效的作用,对于预防、减轻皮疹不良反应和改善患者生活质量具有积极意义。“药毒疹”病机总属“热毒伤阴”,多表现为气阴亏虚在内而热毒结聚于外。根据文献资料及临床经验总结,运用解毒养阴法治疗EGFR-TKIs相关性皮疹具有较好疗效,重视解毒散结、养血润燥,扶正与祛邪同用,标本兼治,谨守病机,精准辨证,灵活用药,中西汇通,减毒增效。文章将结合中医病因病机特点对EGFR-TKIs相关性皮疹的治疗进行探讨,以启医道同仁。Targeted drugs can bind specifically to oncogene loci and induce specific death of cancer cells.At present,EGFR-TKIs targeted drugs have been widely used in the treatment of EGFR mutation-positive non-small cell lung cancer,but the adverse reactions caused by such drugs on the quality of life of patients and therapeutic efficacy can not be ignored.Rash is one of the most common and typical adverse reactions in the treatment of EGFR-TKIs,which belongs to the category of“drug toxicity”and“drug poison rash”in traditional Chinese medicine,and its impact on the quality of life of patients may lead to the interruption or even termination of treatment.The combination therapy of traditional Chinese medicine and targeted drugs can play a role in reducing toxicity and increasing efficiency,which is of positive significance in preventing and alleviating adverse reactions of rash and improving the quality of life of patients.The pathogenesis of“drug poison rash”is“heat poison and injury of Yin(阴)”,which is mostly manifested as Qi(气)and Yin deficiency inside and heat poison accumulation outside.According to the literature and clinical experience,the detoxification and nourishing Yin therapy has a good effect on EGFR-TKIs related rash.Attention should be paid to detoxification and dispersing,nourishing blood and moistening dryness,treating both symptoms and root causes by the same treatment,strictly adhering to the pathogenesis,precise differentiation of syndroms,and flexible medication,and integrating traditional Chinese medicine and Western medicine,so as to achieve the purpose of reducing toxicity and increasing effect.This article will discuss the treatment of EGFR-TKIs related rash in combination with its etiology and pathogenesis of traditional Chinese medicine,so as to inspire medical colleagues.

关 键 词：中医药 解毒养阴 皮疹 表皮生长因子受体-酪氨酸激酶抑制剂 靶向治疗 

分 类 号：R275[医药卫生—中医皮科]