从三焦辨证论治化疗不良反应OA
Treatment of Side Effects of Chemotherapy Based on Syndrome Differentiation of Triple Energizer
化疗药物的毒性特征可对应毒邪理论中的六大特性,其中化疗后消化道不良反应最为常见,故肿瘤化疗药物的毒性主要表现为湿毒之性.这种湿毒日久容易出现湿毒化热,形成湿热,湿热内蕴可引起水液代谢失常和血液运行不畅,从而导致痰湿内生、瘀血形成.部分化疗药物的湿毒之性峻烈,发病急骤,病情变化迅速,具有一定危险性,常累及多系统、多器官.化疗毒邪是药毒内侵,故可直接伤及脏腑.基于此,可以借鉴湿温病的三焦辨证体系,辨治化疗引起的湿毒症状.需注意的是,化疗毒邪的传变路径是由内向外的,其侵犯上焦时,较少表现为肺卫表证,而是多见半表半里的少阳证,临床可采用小柴胡汤进行加减治疗;若化疗湿毒侵犯中焦脾胃,症状主要出现在脾胃,可选用三仁汤进行加减治疗;若化疗湿毒侵犯下焦,症状主要出现在肾、膀胱或大肠等部位,可以三妙丸为基础方进行加减治疗.
The toxic characteristics of chemotherapeutic drugs can correspond to the six major properties of pathogenic toxins in toxin theory.Among them,gastrointestinal adverse reactions after chemotherapy are the most common.Therefore,the toxicity of antitumor chemotherapeutic drugs is mainly manifested as dampness toxin.With prolonged persistence,this dampness toxin is prone to transform into heat,forming dampness-heat.The internal accumulation of dampness-heat can lead to disorders of water-fluid metabolism and impaired blood circulation,thereby resulting in the formation of phlegm-dampness and blood stasis.Some chemotherapeutic drugs possess intense dampness-toxin properties,characterized by sudden onset and rapid changes in the disease condition,with certain risks,and they often involve multiple systems and organs.Chemotherapy toxins belong to medicinal toxins invading internally and can therefore directly damage the Zang-fu organs.Based on this understanding,the triple energizer syndrome differentiation system used in dampness-warm disease can be referenced to differentiate and treat the dampness-toxin symptoms induced by chemotherapy.It should be noted that the transmission of chemotherapy toxins proceeds from the interior to the exterior.When chemotherapy toxins affect the upper energizer,they rarely manifest as lung-defensive exterior syndromes,but more commonly present as Shaoyang syndrome with half-exterior and half-interior characteristics.Clinically,modified Xiaochaihu Decoction can be applied.If chemotherapy dampness toxin invades the spleen and stomach of the middle energizer,symptoms mainly appear in the spleen and stomach,and modified Sanren Decoction can be used for treatment.If chemotherapy dampness toxin invades the lower energizer,symptoms mainly occur in the kidneys,bladder,or large intestine,and treatment can be based on Sanmiao Pills with appropriate modifications.
边卓琼;蔡云;刘昳
西安市第五医院治未病科(陕西 西安 710000)西安交通大学第一附属医院中医科(陕西 西安 710061)西安交通大学第一附属医院中医科(陕西 西安 710061)
化疗不良反应湿温病湿毒三焦辨证小柴胡汤三仁汤三妙丸
side effects of chemotherapydampness-warm diseasesdampness toxinsyndrome differentiation based on the triple energizerXiaochaihu DecoctionSanren DecoctionSanmiao Pills
《基层中医药》 2026 (3)
35-40,6
国家中医药管理局郑清莲全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75号)陕西省中医药管理局中医药传承创新暨"秦药"开发重点科学研究项目(2021-03-ZZ-003)陕西省中医药管理局中医药"双链融合"中青年科研创新团队建设项目(2022-SLRH-YQ-011)
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