从益气养阴解毒法论治肝癌相关血小板减少症  

Treatment of hepatocellular carcinoma-associated thrombocytopenia with the method of benefiting Qi nourishing Yin and detoxifying toxins

作　　者：石宛鑫 闫慧文 于莉华 解宇晴 商子梦 蔡雪 梁羽玲 杨志云[2] SHI Wan-xin;YAN Hui-wen;YU Li-hua;YANG Zhi-yun(First Clinical Medical College,Beijing University of Chinese Medicine,Department of Gastroenterology(Beijing,100700),China)

机构地区：[1]北京中医药大学第一临床医学院,北京100700 [2]首都医科大学附属北京地坛医院

出　　处：《中西医结合肝病杂志》2025年第2期226-229,共4页Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases

基　　金：国家自然科学基金面上项目(No.82274479);首都卫生发展科研专项(No.2020-2-2173);高层次公共卫生技术人才建设项目(学科带头人-02-16);北京市医院管理中心重点医学专业发展计划(No.ZYLX202127);北京市医院管理中心“登峰”人才培养计划(No.DFL20191803);中医药防治传染性重症肝病研究与转化联合实验室(No.DTTP-202301)。

摘　　要：肝癌相关性血小板减少症是肝癌并发症的常见类型之一,可导致皮肤黏膜、消化道出血,甚至死亡。由于肝脏、肿瘤与血小板的密切关系及现代抗癌药物具有肝毒性等副作用,中药在治疗该病时具有独特优势。本文主要介绍肝癌直接或间接导致血小板减少症的理论依据,针对病机确定治疗原则,并基于药理学研究推荐有应用潜力的中药。肝脾肾功能紊乱导致阴阳失调,气血不和,脏腑衰惫,久滞成瘀,累瘀成癌,而癌毒势强,现代医学采用放化疗及“靶向免疫”等治疗以毒攻毒,最终癌、药等毒耗气伤血愈重,因此认为肝癌的病机为气阴两虚、瘀毒内蕴,主张以益气养阴解毒为主要治疗原则,以益气养阴为主,辅以解毒祛瘀。Hepatocellular carcinoma-associated thrombocytopenia is one of the common types of complications of hepatocellular carcinoma,which can lead to bleeding from skin mucosa and digestive tract,and in serious cases,it can lead to death of patients.Due to the close relationship between liver,tumor and platelet and the side effects of modern anticancer drugs such as hepatotoxicity,compared with modern medicine,traditional Chinese medicine(TCM)therapy of motherland medicine has a unique advantage in treating this disease.This article mainly introduces the theoretical basis of thrombocytopenia caused directly or indirectly by hepatocellular carcinoma,determines the therapeutic principles for the disease mechanism,and recommends Chinese medicines with application potential according to the therapeutic principles and modern pharmacological research.The dysfunction of liver,spleen and kidney leads to the imbalance of Yin and Yang,the disharmony of Qi and blood,the exhaustion of internal organs,the stagnation becomes stasis for a long period of time,and the stasis becomes cancer.The toxicity of cancer is strong,and modern medical products such as radiotherapy and"targeted and immunotherapy"use toxicity to fight toxicity,in the end,cancer,medicine and other toxins consume Qi and injure blood more and more,therefore,this article considers that the pathogenesis of hepatocellular carcinoma is deficiency of Qi and Yin,and stasis and toxicity are embedded within the liver.In terms of treatment,it is advocated to benefit Qi,nourish Yin and remove toxins as the main treatment principle.

关 键 词：肝癌 血小板减少症 气阴两虚 益气养阴解毒 

分 类 号：R255.7[医药卫生—中医内科学] R558[医药卫生—中医学]