基于“随其所得”理论探析骨髓增生异常综合征的中医证治  

A brief discussion on TCM diagnosis and treatment of myelodysplastic syndrome based on the Theory of"Sui Qi Suo De"

作　　者：戚云鹤 谌海燕[2] 郭明[2] 刘军霞[2] 李玲[2] 廖俊尧 廖婧[2] 丁晓庆[2] Qi Yunhe;Chen Haiyan;Guo Ming;Liu Junxia;Li Ling;Liao Junyao;Liao Jing;Ding Xiaoqing(Master Degree Student of Grade 2022,the Second Clinical Medical College,Beijing University of Chinese Medicine,Beijing 100029,China;Department of Hematology,Dongfang Hospital of Beijing University of Chinese Medicine,Beijing 100078,China)

机构地区：[1]北京中医药大学第二临床医学院,北京100029 [2]北京中医药大学东方医院血液科,北京100078

出　　处：《国际中医中药杂志》2025年第3期294-297,共4页International Journal of Traditional Chinese Medicine

基　　金：北京市科技计划项目(Z161100000516059);北京中医药大学2023年新教师启动基金项目(2023-JYBXJSJJ044)。

摘　　要：“随其所得”理论源于张仲景的《金匮要略》,并得到后世医家的丰富和发展,对临证具有重要的指导意义。骨髓增生异常综合征(MDS)为血液系统常见恶性肿瘤,具有高度异质性和进展突变性,属中医“髓毒劳”范畴。本文试从中医“随其所得”理论出发,以MDS疾病发生发展过程中各个阶段的病机变化为切入点,分析MDS前驱期(养生调摄、未病先防,以治“正气渐虚”之“所得”)、低危期(健脾益肾、清透毒邪,以治“正虚邪侵”之“所得”)、中高危期(解毒扶正、形神并调,以治“邪盛正衰”之“所得”)3个不同阶段的证候特征及选方用药,以期为MDS的中医治疗提供方向和理论参考。The theory of"Sui Qi Suo De"originates from Zhang Zhongjing's Jin Gui Yao Lue and has been further developed by later generations of practitioners,offering significant guidance for clinical practice.Myelodysplastic syndromes(MDS)are common malignant disorders of the hematopoietic system,characterized by high heterogeneity and progressive mutational changes.In Traditional Chinese Medicine(TCM),MDS falls under the category of"marrow toxin exhaustion".This article applies the theory of"Sui Qi Suo De"in TCM to analyze the pathophysiological changes during different stages of MDS.Specifically,it explores the precursor stage(focusing on health maintenance and prevention before illness,addressing the"Suo De"of"gradual decline of vital qi"),the low-risk stage(strengthening the spleen and kidneys,clearing toxic pathogens,addressing the"Suo De"of"weakened vital qi invaded by pathogens"),and the medium-to-high-risk stage(detoxifying and reinforcing the body,harmonizing physical and mental health,addressing the"Suo De"of"dominant pathogens and declining vital qi").The goal is to provide new directions and theoretical insights for the TCM treatment of MDS.

关 键 词：骨髓增生异常综合征 随其所得 分期论治 

分 类 号：R55[医药卫生—血液循环系统疾病]