刘丽坤从"攻补兼施"论治手足综合征临床经验OA

Hand-foot syndrome(HFS)is a common dose-limiting adverse reaction in oncology patients undergoing chemotherapy or targeted therapy.Professor Liu Likun posits that its core pathogenesis is characterized by"spleen-stomach deficiency as the root,and blood stasis obstructing the collaterals as the manifestation".Based on the distinct properties of the drugs,she further proposes that chemotherapeutic agents are mostly categorized as"cold toxins",which damage yang and lead to cold coagulation and blood stasis,whereas targeted agents are mostly categorized as"heat toxins",which consume yin and result in heat-stasis intermingling.Treatment follows the principle of"simultaneous elimination and reinforcement",emphasizing the integration of disease stage and etiological differentiation:in the early stage,treatment focuses on unblocking the collaterals,with warming and unblocking for chemotherapy-induced HFS and cooling and dispersing for targeted therapy-induced HFS;in the middle stage,treatment focuses on attacking pathogens,with warming and unblocking stasis for chemotherapy-induced HFS and cooling blood and dispersing stasis for targeted therapy-induced HFS;in the late stage,treatment focuses on strengthening vital qi and consolidating the root,with warming yang and expelling toxins for chemotherapy-induced HFS and nourishing yin and clearing heat for targeted therapy-induced HFS.For cold-heat complex cases induced by combined medication,treatment should harmonize both cold and heat simultaneously.The integrated strategy of internal and external treatment,combining elimination and reinforcement,can effectively alleviate symptoms,ensure continuity of anti-tumor therapy,and demonstrate the distinctive advantages of traditional Chinese medicine.