张志明教授治疗化疗后骨髓抑制的临床经验撷菁  

Professor ZHANG Zhiming’s clinical experience in the treatment of bone marrow suppression after chemotherapy

作　　者：王艳敏 黄邦荣[2] 张志明 WANG Yanmin

机构地区：[1]甘肃中医药大学,甘肃兰州730000 [2]甘肃省中医院,甘肃兰州730050

出　　处：《中医临床研究》2025年第1期86-90,共5页Clinical Journal Of Chinese Medicine

摘　　要：化疗后骨髓抑制是常见的不良反应之一,是患者在治疗中的主要障碍,严重者影响治疗进程,降低治疗效果。中医学认为,脾与肾先天促后天,后天养先天。肾藏精,元气根于肾。元气盛则脾气健旺,运化水谷精微。脾化生后天之精并不断输送至肾,充养先天之精,使之生化不息。人体血液的生成,一方面是后天脾胃运化的水谷精微上输于心、肺而化赤为血,另一方面是肾精生髓,髓充于骨,骨中精髓为化生血液之源。气和精血是构成和维持人体生命活动的基本物质。其中,气属阳,精和血属阴,正如《素问·阴阳应象大论篇》中记载:“阴在内,阳之守也;阳在外,阴之使也。”精和血是阳气固守于外的物质基础。阳气主外,为精和血生成、输布的动力。气和精血阴阳和谐,运行输布正常,则机体得养,人体生命活动正常。张志明教授熟读医家经典,根据多年临床经验总结得出,命门之火乃肾中之阳。化疗药毒属于“寒邪”,寒邪入侵,机体阳气受损,故见虚象,临床以脾肾阳虚为主,治疗当温肾健脾、益气养血,其自拟方益髓生血方在化疗后骨髓抑制的治疗中疗效显著。本研究整理张教授对化疗后骨髓抑制的经验,以飨同道。Myelosuppression after chemotherapy is one of the common adverse reactions,which is the main obstacle of patients in the treatment,and in severe cases,it affects the treatment process and reduces the treatment effect.Traditional Chinese medicine believes that the spleen and kidney are congenitally promoted and acquired.The kidneys store essence,and the vitality is rooted in the kidneys.When the vitality is strong,he spleen is strong and can transport water and grain essences.The spleen metamorphosis gives birth to the acquired essence,which is continuously transported to the kidneys to nourish the innate essence and make it biochemical endlessly.The reasons for the generation of human blood are as following:on the one hand,the transfusion of water and grain essences into the heart and lungs by the acquired spleen and stomach.On the other hand,the essence of the kidney gives birth to bone marrow,the marrow fills the bone,and the essence in the bone is the source of metaplastic blood.Qi(气),essence and blood are the basic substances that constitute and sustain the vital activities of the human body.Among them,Qi belongs to Yang(阳),and essence and blood belong to Yin(阴),such as Suwen·Yin Yang Yingxiang Dalun Pian(《素问·阴阳应象大论篇》):“Yin is inside,and Yang is guarded,Yang is outside,and Yin is also the messenger.”Essence and blood are the material basis for Yangqi(阳气)to be fixed outside.Yangqi dominates the outside,which is the driving force of the generation and infusion of essence and blood.Qi and essence blood,Yin and Yang are harmonious,the operation is normal,and the body is nourished,then the human body’s vital activities are normal.Professor ZHANG Zhiming is familiar with the classics of medical experts,and based on years of clinical experience,has concluded that the fire of life is the Yang in the kidneys.Chemotherapy drug poison belongs to the“cold evil”,the cold evil invades,the body’s Yangqi is damaged,so the deficiency symptoms is seen.The spleen and kidney Yang def

关 键 词：骨髓抑制 化疗 脾肾同治 益髓生血方 

分 类 号：R73[医药卫生—肿瘤]