仝小林治疗化疗所致腹泻验案1则  

A case study of Academician Tong Xiaolin's treatment of chemotherapy-induced diarrhea

作　　者：盛煜栋 李洪皎[1] 张琪 李修洋[2] SHENG Yudong;LI Hongjiao;ZHANG Qi;LI Xiuyang(Institute of Basic Research in Clinical Medicine,China Academy of Chinese Medical Sciences,Beijing 100700,China;Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing 100053,China)

机构地区：[1]中国中医科学院中国临床基础医学研究所,北京100700 [2]中国中医科学院广安门医院,北京100053

出　　处：《吉林中医药》2025年第3期320-324,共5页Jilin Journal of Chinese Medicine

基　　金：北京市自然科学基金-海淀原始创新联合基金(Z0817);中国中医科学院广安门医院临床医学研究中心建设专项资助(2022LYJSZX08)。

摘　　要：报告1例化疗所致腹泻(4级)的中医辨治过程。目前,针对化疗所致严重腹泻以个案报道为主,中医对于化疗所致严重腹泻的诊疗仍在探索阶段。本病例为结肠癌术后应用化疗药联合治疗后出现严重腹泻,西药治疗后腹泻不能缓解,不能及时止泻对于老年患者风险极高。化疗所致腹泻属中医“泄泻”范畴,但与泄泻现有证候难以对应。在此情况下,采用“病证结合”和“宏观微观结合”,组方以黄土汤合补中益气汤加减,患者服用1剂后腹泻次数减半,9剂大便如常,半个月后随访如常。结合本则验案组方思路,具体阐释临床实践中的“病证结合”与“宏观微观结合”,并将组方思路以图的形式呈现,以期为临床医生开展“病证结合”与“宏观微观结合”提供参考。This paper reports the traditional Chinese medicine(TCM)syndrome differentiation and treatment process in a case of chemotherapy-induced diarrhea(Grade 4).At present,the management of severe chemotherapy-induced diarrhea is primarily documented through case reports,and the diagnosis and treatment of severe chemotherapy-induced diarrhea in TCM is still in the exploratory phase.In this case,severe diarrhea occurs following postoperative chemotherapy for colon cancer.The condition does not improve with the use of western medicines,and the risk is extremely high for the elderly patient if diarrhea cannot be promptly controlled.Chemotherapy-induced diarrhea is classified under the TCM category of"diarrhea",but the existing syndromes do not correspond well.In this context,a treatment approach combining"disease-syndrome integration"and"macro-micro integration"is adopted,employing a prescription of modified Huangtu Decoction combined with Buzhong Yiqi Decoction.After taking one dose,the frequency of diarrhea in the patient is halved,and normal bowel movements are restored after nine doses.A follow-up visit half a month later confirms the normalization of bowel movements.This case study elaborates on the clinical application of"disease-syndrome integration"and"macro-micro integration"and presents the prescription strategy in a graphical form,aiming to provide a reference for clinicians to enhance their practice with these integrative approaches.

关 键 词：化疗所致腹泻 严重腹泻 中医辨治 病证结合 宏观微观结合 

分 类 号：R249[医药卫生—中医临床基础]