摘要
目的 通过对阿帕替尼所致手足综合征(Hand-foot syndrome,HFS)进行中医辨证分型,为中医药认识及治疗HFS提供理论证据及指导参考。方法 选取江西中医药大学附属医院肿瘤科2019年1月—2021年4月住院部和门诊收治的行阿帕替尼治疗的恶性肿瘤患者20例,采用Kaplan-Meier单因素法、Cox多因素回归分析方法,研究影响阿帕替尼所致HFS临床疗效的独立性相关因素,讨论中医辨证综合防治HFS的临床效果,探究阿帕替尼所致HFS的独立预后因素与最佳中医防治方案。结果 经过临床观察,所收集的20例HFS患者在予以对症治疗后,症状均有所缓解。通过辨证分型,将20例HFS患者的证型分为实证和虚证,其中实证包含血虚风燥证、热毒蕴肤证,虚证包含气血亏虚证、气阴两伤证。常见症状有:四肢麻木、乏力、手足溃烂、胸闷。HFS发生的天数大多在1~10 d及10~20 d。结论 阿帕替尼治疗后所引起的HFS患者的中医分型有热毒蕴肤证、血虚风燥证、气血亏虚证、气阴两伤证,并以气阴两伤证、热毒蕴肤证为主。
Objective Through TCM syndrome differentiation and classification of hand-foot syndrome(HFS)caused by Apatinib,theoretical evidence and guidance are provided for TCM understanding and treatment of HFS.Methods Twenty patients with malig-nant tumors treated with Apatinib in Affiliated Hospital of Jiangxi University of Chinese Medicine from January 2019 to April 2021 were selected.Kaplan-Meier single factor method and Cox multi-factor regression analysis were used to study the independent related factors affecting the clinical efficacy of Apatinib-induced HFS,discuss the clinical effect of TCM syndrome differentiation and com-prehensive prevention and treatment of HFS,and explore the independent prognostic factors and the best TCM prevention and treat-ment plan of Apatinib-induced HFS.Results After clinical observation,the symptoms of 20 patients with HFS were relieved after symptomatic treatment.Through syndrome differentiation,the syndrome types of 20 HFS patients were divided into positive syndrome and deficiency syndrome.The positive syndrome included blood deficiency and wind-dryness syndrome,heat toxicity syndrome,and deficiency syndrome included qi and blood deficiency syndrome and qi and yin injury syndrome.Common symptoms were as follows:limbs numbness,fatigue,festering hands and feet,chest tightness.The days of HFS occurrence are mostly from 1 to 10 days and 10 to 20 days.Conclusion The TCM types of Apatinib-induced HFS include syndrome of heat toxicity and skin accumulation,syndrome of blood deficiency and wind dryness,syndrome of qi and blood deficiency and syndrome of qi and yin injury,and mainly syndrome of qi and yin injury and syndrome of heat toxicity and skin accumulation.
作者
楚瑞阁
郑舞
梅丽俊
钟美林
徐婷
CHU Ruige;ZHENG Wu;MEI Lijun;ZHONG Meiin;XU Ting(Department of Oncology,Affiliated Hospital of Jiangxi University of Chinese Medicine,Jiangxi Province,Nanchang 330006,China;Department of Integrated TCM&Western Medicine,Jiangxi Cancer Hospital,Jiangxi Province,Nanchang 330029,China;Department of Internal Medicine,Longchuan County Central Hospital,Guangdong Province,Longchuan 517300,China)
出处
《中国中医药现代远程教育》
2023年第17期57-59,共3页
Chinese Medicine Modern Distance Education of China
基金
江西省卫生计生委中医药科研项目【No.2018A056】
国家中医药管理局第五批全国中医临床优秀人才研修项目【No.国中医药人教函[2022]1号】。
