从《金匮要略》血痹病探讨手足综合征的中医辨治OA

Based on the theory of blood Bi syndrome(血痹病)in ZHANG Ji's Jingui Yaolue(《金匮要略》),this paper explores traditional Chinese medicine(TCM)syndrome differentiation and treatment for chemotherapy-induced hand-foot syndrome(HFS).Although HFS is a cutaneous toxic reaction of chemotherapy in modern medicine,its clinical manifestations and pathogenesis are highly consistent with those of blood Bi syndrome,both being root-deficiency and branch-excess disorders.The root cause is Qi(气)blood deficiency and defensive Yang(阳)insufficiency:cancer patients inherently have deficient healthy Qi,and chemotherapy toxins further damage Yang Qi and consume nutrient blood,depriving the extremities of warmth and nourishment.The branch manifestations,including nutrient Yin(阴)stagnation,blood stasis,collateral obstruction,and meridian malnourishment,result from toxic invasion and poor Qi-blood circulation,leading to numbness,pain,erythema,swelling,and dry scaly skin in the extremities.Treatment prioritizes tonifying Qi-blood and harmonizing nutrient-defensive Qi,focuses on activating blood circulation to resolve stasis and unblock collaterals for pain relief,and is supplemented by warming Yang,invigorating the spleen,and relieving Bi syndrome.The combination of strengthening healthy Qi,resolving stasis,and warming Yang precisely targets the pathogenesis.Clinically,the Huangqi Guizhi Wuwu Tang(黄芪桂枝五物汤)serves as the basic prescription with symptomatic modifications:Huangqi(Astragali Radix)tonifies Qi and consolidates the exterior,Guizhi(Cinnamomi Ramulus)warms meridians,Shaoyao(Paeoniae Radix Alba)nourishes blood,and Shengjiang(Zingiberis Rhizoma Recens)combined with Dazao(Jujubae Fructus)regulates the spleen and stomach,jointly exerting the effects of strengthening healthy Qi and unblocking Bi syndrome.Symptomatic modifications address blood stasis,collateral unblocking,Yang warming,and spleen invigoration,which alleviates local symptoms,protects healthy Qi,reduces chemotherapy side effects,and ensures the smooth implementation of anti-tumor treatment.A typical proven case is attached to provide empirical evidence for clinical promotion.