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孙启蒙,李晓丽,刘丽坤.刘丽坤教授从“伏毒-络病”角度分期辨治紫杉醇诱导的周围神经病变[J].湖南中医药大学学报,2024,44(3):455-460[点击复制] |
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刘丽坤教授从“伏毒-络病”角度分期辨治紫杉醇诱导的周围神经病变 |
孙启蒙,李晓丽,刘丽坤 |
(山西中医药大学, 山西 太原 030024;山西省中医院, 山西 太原 030012) |
摘要: |
周围神经病变是紫杉醇药用后常见的不良反应,其症状缠绵难愈且容易复发。结合其临床表现,刘丽坤教授从中医学的“伏毒-络病”角度进行论治,认为药毒损络致络脉失和是核心病机,毒、瘀、虚是其发生、发展的内在病理因素。治疗上根据络病传变规律和不同阶段的伏毒病机特点分期辨治:急性发作期通达气络,调和营卫;慢性难愈期通阳化瘀,益气解毒;渐进肌痿期填益骨络,扶阳托毒,临床疗效明显。 |
关键词: 周围神经病变 紫杉醇 伏毒 络病 通调营卫 化瘀解毒 扶阳托毒 刘丽坤 |
DOI:10.3969/j.issn.1674-070X.2024.03.016 |
投稿时间:2023-09-28 |
基金项目:国家中医药管理局全国名老中医药专家传承工作室建设项目(国中医药人教函〔2022〕75号);国家中医药传承创新中心的建设项目(202203);山西省医学科技创新团队建设任务项目(2020TD04)。 |
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Professor LIU Likun's staged treatment of paclitaxel-induced peripheral neuropathy from the perspective of "latent toxin-collateral disease" |
SUN Qimeng,LI Xiaoli,LIU Likun |
(Shanxi University of Chinese Medicine, Taiyuan, Shanxi 030024, China;Shanxi Academy of Chinese Medicine, Taiyuan, Shanxi 030012, China) |
Abstract: |
Peripheral neuropathy is a common adverse reaction of paclitaxel, and its symptoms are lingering and easy to relapse. Combined with its clinical manifestations, Professor LIU Likun treats it from the perspective of "latent toxin-collateral disease" in Chinese medicine. She believes that its core pathogenesis is the disharmony of collaterals due to drug toxins, with toxin, stasis, and deficiency as the internal pathological factors of its occurrence and development. Hence, the treatment should be based on the transmission law of collateral diseases and the pathogenesis characteristics of latent toxins at different stages. During the acute exacerbation stage, it is essential to circulate qi and unblock the collaterals as well as to harmonize ying and wei; during the chronic hard-to-heal stage, it is significant to unblock yang and transform stasis as well as to tonify qi and remove toxins; during progressive muscular atrophy stage, it is vital to refill the bones and benefit collaterals as well as to support yang and expel toxins, which exerts remarkable therapeutic effects. |
Key words: paclitaxel peripheral neurotoxicity latent toxin collateral disease harmonizing ying and wei transforming stasis and removing toxins supporting yang and expelling toxins LIU Likun |
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