张维骏教授运用苓术和中汤治疗化疗相关恶心呕吐的临床经验OA

Chemotherapy-induced nausea and vomiting(CINV)is a common toxic reaction in cancer patients during chemotherapy,which falls under the categories of"vomiting"and"fullness"in traditional Chinese medicine.Its core patho-genesis is that most chemotherapeutic agents are potent and tend to impair the functions of the spleen and stomach,leading to disruption of the Qi activity in the middle energizer,ultimately causing failure of the stomach to descend normally and up-ward rebellion of stomach Qi.Based on the modified Zhuling Decoction from Chen Shiduo's Bian Zheng Lu,Professor Zhang Weijun integrates his own clinical experience and develops the specialized formula Lingzhu Hezhong Decoction.The formula consists of Renshen,bran-fried Baizhu,Fuling,ginger-prepared Banxia,Zhuru,Huangqi,Chenpi,Dingxiang,ginger,Zhiqiao and Shidi.The whole formula uses Renshen,Huangqi,Baizhu and Fuling to tonify the deficiency of the middle ener-gizer;Dingxiang,ginger and Banxia to warm the cold of the middle energizer;and is complemented by Chenpi,Zhiqiao and Shidi to regulate Qi and lower the adverse flow,ensuring tonification without stagnation,warming without dryness,and lower-ing without damaging healthy Qi.Together,the formula achieves the effects of strengthening the spleen and replenishing Qi,warming the middle energizer to stop vomiting,and reinforcing healthy Qi to consolidate the root.Considering the differences in constitution and syndrome patterns of patients after chemotherapy,Prof.Zhang further classifies CINV into five syndrome types:Qi deficiency of the spleen and stomach,internal obstruction of phlegm-dampness,stomach deficiency with heat,deficiency-cold of the spleen and stomach and mixed cold and heat.Based on Lingzhu Hezhong Decoction,he flexibly modi-fies the formula accordingly.Clinical verification has shown that this syndrome differentiation and modification approach aligns with the pathogenesis and can significantly improve the clinical symptoms of CINV.