从“急性虚证”探讨放射治疗、化学治疗后骨髓抑制论治思路  

Exploring the treatment approach for bone marrow suppression after radiotherapy and chemotherapy from the perspective of"acute deficiency syndrome"

作　　者：李志明 黄芬 姜家旺 江威 陈小春 李鑫[2] LI Zhiming;HUANG Fen;JIANG Jiawang;JIANG Wei;CHEN Xiaochun;LI Xin(Affiliated Hospital of Jiangxi University of Chinese Medicine,Nanchang 330006,China;Longhua Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai 200030,China)

机构地区：[1]江西中医药大学附属医院,南昌330006 [2]上海中医药大学附属龙华医院

出　　处：《北京中医药大学学报》2025年第1期122-126,共5页Journal of Beijing University of Traditional Chinese Medicine

基　　金：2024年江西省重点研发计划项目(No.20243BBI91027);第五批全国中医临床优秀人才研修项目(国中医药人教函[2022]1号)。

摘　　要：骨髓抑制是放射治疗(简称“放疗”)、化学治疗(简称“化疗”)常见的不良反应之一。放、化疗等抗肿瘤治疗首先直接杀伤患者外周血细胞,损伤气血;进一步杀伤骨髓增殖活跃的细胞群,损伤阴血;再进一步干扰造血干细胞,损伤精血。这个过程迅速而猛烈,符合“急性虚证”起病急、变化快、病情危重、复杂多变、并发症多、预后差等特点。鉴于此,其辨治与一般虚证当有明显差异。本文提出“预防为先,早治防变;峻补其虚,扶正祛邪;急补救危,刻不容缓;全程补益,甚者独行”的辨治原则和思路,以期为放、化疗后骨髓抑制提供理论参考和实践借鉴。Bone marrow suppression is one of the common adverse reactions to radiotherapy and chemotherapy.Anticancer treatments such as radiotherapy and chemotherapy first directly damage the patient's peripheral blood cells,impairing qi and blood;further,they damage the actively proliferating cell populations in the bone marrow,impairing yin and blood;and then they interfere with hematopoietic stem cells,impairing essence and blood.This process is rapid and intense,consistent with the characteristics of"acute deficiency syndrome",marked by sudden onset,rapid changes,critical condition,complexity and variability,multiple complications,and poor prognosis.Given this,its diagnosis and treatment should differ from those of general deficiency syndromes.This paper advocates the principles and ideas of diagnosis and treatment such as"preventing first and treating early to prevent changes;supplementing for deficiency and strengthening vital qi to eliminate pathogenic factor;urgent rescue for critical conditions,no time to lose;and comprehensive supplementing throughout the process,with severe cases requiring singular action".This approach is intended to provide theoretical reference and practical guidance for bone marrow suppression after radiotherapy and chemotherapy.

关 键 词：急性虚证 骨髓抑制 放射治疗 化学治疗 

分 类 号：R273[医药卫生—中西医结合]