摘要
化疗相关周围神经病变(chemotherapy-induced peripheral neuropathy,CIPN)在中医范畴可归为“血痹”“痹证”。刘丽坤教授结合“虚气留滞”理论阐释CIPN病机,认为“虚”为CIPN发病基础,“滞”是病理关键,二者互为因果。临床治疗以“补虚行滞”为基本大法,以补虚固本、行气通滞为内治原则,辅以中医外治法直达病所,形成一套“内外合治”的治疗体系,并且针对不同分级的CIPN进行分级论治:轻度病机为阳气初损、虚而未损、滞而未结,治宜“轻补缓通”;中度病机为气血亏虚、肝肾受损、邪滞胶结,治应“补通并重”;重度病机为元气大亏、肝肾俱损,治疗应“大补元气、破瘀通络”。本文从“虚气留滞”理论探讨CIPN治疗,并附临床医案两则,以期为临床治疗CIPN提供诊疗思路。
Chemotherapy-induced peripheral neuropathy(CIPN)falls under the categories of blood impediment and impediment syndrome.Professor Liu Likun explains the pathogenesis of CIPN by integrating the theory of“deficiency qi induced retention and stagnation”,holding that“deficiency”serves as the fundamental basis for CIPN onset,while“stagnation”is the key pathological factor,and the two interact as both cause and effect.In clinical practice,the core treatment principle for CIPN is“replenishing deficiency and resolving stagnation”.For internal treatment,the strategies of“replenishing deficiency to consolidate the root”and“activating qi to resolve stagnation”are adopted,supplemented by Traditional Chinese medicine external therapies that act directly on the affected sites,which forms a comprehensive“integrated internal-external treatment”system.Furthermore,a grading treatment approach is implemented for CIPN of different severity levels.For mild CIPN,the pathogenesis is characterized by“initial impairment of yang qi,deficiency without severe damage,and stagnation without accumulation”,calling for the treatment principle of“mild replenishment and gentle dredging”.For moderate CIPN,the pathogenesis involves“deficiency of qi and blood,impairment of liver and kidney,and accumulation of pathogenic stagnation”,requiring the principle of“equal emphasis on replenishment and dredging”.For severe CIPN,the pathogenesis manifests as“severe deficiency of primordial qi and impairment of both liver and kidney”,demanding the principle of“greatly replenishing primordial qi and breaking stasis to dredge collaterals”.This article explores the treatment of CIPN from the perspective of“deficiency qi induced retention and stagnation”theory and presents two clinical cases,aiming to provide practical insights for the clinical management of CIPN.
作者
郭佳慧
肖状
裴正颖
刘丽坤
郝淑兰
GUO Jiahui;XIAO Zhuang;PEI Zhengying;LIU Likun;HAO Shulan(The First Clinical College,Shanxi University of Chinese Medicine,Taiyuan 030024 Shanxi,China;The Third Clinical College,Shanxi University of Chinese Medicine,Taiyuan 030024 Shanxi,China;Department of Oncology,Shanxi Institute of Traditional Chinese Medicine,Taiyuan 030012 Shanxi,China)
出处
《中医肿瘤学杂志》
2025年第6期106-113,共8页
Journal of Oncology in Chinese Medicine
基金
结直肠癌肝转移中西医治疗策略及示范推广应用(编号:YDZJSX20231C020)。
关键词
虚气留滞
化疗相关周围神经病变
补虚
行滞
名医经验
deficiency qi induced retention and stagnation
chemotherapy-induced peripheral neuropathy
replenishing deficiency
resolving stagnation
experience of renowned physicians
