摘要
口腔黏膜炎是恶性肿瘤患者化学治疗后的常见不良反应,中医药治疗具有独到的作用。基于中医理论的认识,口腔黏膜炎是局部郁火证,化疗药物虽寒热属性不一,因其为有毒之品,能损伤脾胃功能,能导致火郁证。郁火的产生包括四方面:火热炽盛,热毒内结;中焦凉遏,阳热内郁;土虚气郁,阴火不制;湿邪内停,湿阻阳郁。针对此病机,不能过用苦寒直折药物,当以清热散郁、升阳散郁、扶正散郁、宣湿散郁四法宣散郁火。清热散郁法包括导赤散、清胃散、泻黄散等,升阳散郁包括升阳散火汤,扶正散郁包括甘草泻心汤、补中益气汤等,宣湿散郁包括三仁汤等。除此四法,可结合"态靶并治"法,配伍时加入针对局部火热证的药物。本文探讨宣散郁火法在化疗性口腔黏膜炎中的应用,为临床应用提供参考。
Oral mucositis is the common adverse reaction induced by chemotherapy in patients with malignant tumors,and traditional Chinese medicine(TCM)has shown unique role in the treatment of oral mucositis. Based on the TCM theory, oral mucositis can be differentiated as the syndrome of local stagnated fire. Although chemotherapeutic drugs are different in the property of cold and heat,they are toxic and can injure the function of spleen and stomach, which can lead to stagnated fire syndrome. The stagnated fire can be generated from the following four methods: abundant fire-heat and internal accumulation of heat toxicity lead to stagnated fire;middle-energizer is obstructed by cold-pathogen and then the stagnation of Yang and heat causes the stagnated fire;spleen and stomach deficiency and qi stagnation lead to yin fire hyperactivity;retention of dampness evil leads to yang stagnation. In view of the pathogenesis, bitter-cold anti-pyretic herbs are not suitable for the treatment of oral mucositis,and four methods can be adopted,i.e.,clearing heat and dissipating stagnated fire,ascending yang and dissipating stagnated fire,tonifying deficiency and dissipating stagnated fire,and dispersing dampness and dissipating stagnated fire. Clearing heat and dissipating stagnated fire can be achieved by using Daochi San,Qingwei San,Xiehuang San. Ascending yang and dissipating stagnated fire can be achieved by using Shengyang Sanhuo Decoction. Tonifying deficiency and dissipating stagnated fire can be achieved by using Gancao Xiexin Decoction and Buzhong Yiqi Decoction. And dispersing dampness and dissipating stagnated fire can be achieved by using Sanren Decoction. In addition,herbs for local fire and heat syndrome can be added by following the principle of state-target simultaneous treatment. The discussion on the application of therapy of dissipating stagnated fire in chemotherapy-induced oral mucositis is expected to provide reference for clinical application.
作者
陈晨
贾立群
CHEN Chen;JIA Li-qun(Graduate School,Beijing University of Chinese Medicine,Beijing 100029,China;China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中医肿瘤学杂志》
2022年第1期54-58,共5页
Journal of Oncology in Chinese Medicine
基金
国家自然科学基金(编号:81973693)。
关键词
化疗
口腔黏膜炎
宣散郁火法
理论探讨
chemotherapy
oral mucositis
therapy of dissipating stagnated fire
theoretical discussion
