摘要
贾敏教授认为,肺癌靶向药物所致皮肤毒性可按温病学理论辨证施治。其病机为癌毒侵袭,损伤机体,正气虚损,加上手术、放疗、化疗等,使机体脏腑亏虚,气血津液损伤,防御功能减弱,无力驱邪外出。靶向药物之毒邪滞留于内,毒邪传入卫气营血及三焦所属脏腑,使脏腑、气血失和,肌肤腠理失于充养,发于皮肤而为病。肺癌靶向药物药性多辛热,易伤津耗气,治疗时应辨病与辨证相结合,不忘"观其脉证,知犯何逆,随证治之。"病在初期,可予金银花、连翘、淡竹叶、香薷等轻清类药物;病邪传变,予黄连、黄芩、石膏、知母等清热祛邪;病邪深入下焦、营血,毒邪热郁,伤阴、动风、动血,当以生地黄、麦冬、天冬、玉竹、石斛、女贞子、墨旱莲等重镇之品填补真阴,苦寒之生地黄、牡丹皮、芍药等凉血散血。
According to Professor Jia Min,the skin toxicity of lung cancer targeting drugs can be treated according to the theory of warm diseases.The pathogenesis of the disease is that cancer toxin invasion damages the body,and healthy qi.In addition to,radiotherapy,chemotherapy,etc.cause body viscera deficient,qi and blood body fluid damaged,defense function weakened failing to remove pathogens out.When targeted drug toxicity is stagnated inside body,toxicity pathogen enter the viscera belonging to defense-qi-nutrient-blood and triple-energizer,leading to disharmony between the viscera,qi and blood,then skin and interstitial space lose nutrients,the skin toxicity will occur.Lung cancer target drugs are mostly pungent and hot,easy to injure fluid and consume qi.In terms of treatment,disease differentiation should be combined with syndrome differentiation by observing pulse and syndrome to find out the cause and treat it accordingly.In the early stage of the disease,it can be treated with light medicinals such as Jinyinhua(Flos Lonicerae Japonicae),Lianqiao(Fructus Forsythiae),Danzhuye(Herba Lophatheri),Xiangru(Herba Moslae).When the pathogenic factors have been transmitted and changed,Huanglian(Rhizoma Coptidis),Huangqin(Radix Scutellariae),Shigao(Gypsum Fibrosum),and Zhimu(Rhizoma Anemarrhenae),etc.can be used for clearing away heat and removing pathogenic factors.When the pathogens go deep into lower energizer,nutrient-blood,toxicity and heat are stagnated,leading to injuring yin,generating wind and bleeding,some settling tranquilizer such as Shengdihuang(Radix Rehmanniae),Maidong(Radix Ophiopogonis),Tiandong(Radix Asparagi),Yuzhu(Rhizoma Polygonati Odorati),Shihu(Caulis Dendrobii),Nvzhenzi(Fructus Ligustri Lucidi),Mohanlian(Herba Ecliptae),etc.can be used for nourishing yin,and bitter-cold medicinals such as Shengdihuang(Radix Rehmanniae),Mudanpi(Cortex Moutan),Shaoyao(Radix Paeoniae Alba seu Rubra),etc.can be used for cooling and dispersing blood.
作者
黄鹏
贾敏
HUANG Peng;JIA Min(Guizhou University of TCM,Guiyang,Guizhou,China,550002;The First Affiliated Hospital of Guizhou University of TCM,Guiyang,Guizhou,China,550001)
出处
《河南中医》
2020年第6期859-861,共3页
Henan Traditional Chinese Medicine
基金
国家重点研发计划项目(2018YFC1705301)。
关键词
肺癌
靶向治疗
皮肤毒性
温病学
卫气营血辨证
三焦辨证
贾敏
lung cancer
targeted therapy
skin toxicity
warm diseases
defense-qi-nutrient-blood syndrome differentiation
triple-energizer syndrome differentiation
Jia Min
