| 引用本文: |
张天缘, 蒋怡, 赵文瑶, 刘艳, 郭利华.基于“一体两翼，疏调气机”探讨靶向治疗药物相关皮肤不良反应之病机演变及治疗[J].湖南中医药大学学报,2026,46(1):120-125[点击复制] |
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| 基于“一体两翼，疏调气机”探讨靶向治疗药物相关皮肤不良反应之病机演变及治疗 |
| 张天缘,蒋怡,赵文瑶,刘艳,郭利华 |
| (云南中医药大学, 云南 昆明 650011;云南省中医医院, 云南 昆明 650103) |
| 摘要: |
| 基于国医大师张震的“一体两翼，疏调气机”理论，探讨靶向治疗药物相关皮肤不良反应的病机演变规律及分期辨治思路，认为靶向治疗药物相关皮肤不良反应的核心病机为药毒内侵致气机逆乱，沿“气郁毒炽-土壅毒滞-络虚毒恋”传变，即外邪引动肝郁，毒邪始犯肌表；肝郁乘脾生湿，毒浊互结于肌肤；久病及肾入络，毒瘀胶着难解。据此确立分期辨治方案，初期疏肝调气以透邪，清热解毒护肌表；中期疏肝运脾以化浊，解毒利湿和营卫；后期补肾填精固其本，活血通络透伏毒，以期为中医药防治靶向治疗药物相关皮肤不良反应提供新思路及理论依据。 |
| 关键词: 肿瘤 靶向治疗药物相关皮肤不良反应 一体两翼 疏调气机 中药 张震 |
| DOI：10.3969/j.issn.1674-070X.2026.01.016 |
| 投稿时间：2025-08-27 |
| 基金项目:云南省科学技术厅课题（202201AG070216）；云南省教育厅科学研究基金项目（2025Y0637）；云南中医药大学校院联合基金项目（XYLH2023117）。 |
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| Pathogenesis evolution and treatment of skin adverse reactions related to targeted therapy drugs based on the theory of "one body with two wings, regulating and harmonizing qi movement" |
| ZHANG Tianyuan, JIANG Yi, ZHAO Wenyao, LIU Yan, GUO Lihua |
| (Yunnan University of Chinese Medicine, Kunming, Yunnan 650011, China;Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan 650103, China) |
| Abstract: |
| Based on the theory of "one body with two wings, regulating and harmonizing qi movement" proposed by National TCM Master ZHANG Zhen, this study explores the pathogenesis evolution patterns and stage-based differentiation and treatment strategies for skin adverse reactions related to targeted therapy drugs. It is believed that the core pathogenesis of these skin adverse reactions is qi movement disorder caused by the invasion of drug toxins. The disease progresses along the pathway of "qi stagnation with intense toxin－earth (spleen) obstruction with stagnant toxin－collateral deficiency with lingering toxin", that is, exogenous pathogens trigger liver qi stagnation, and toxic pathogens initially attack the skin and muscles; liver qi stagnation affects the spleen, leading to the production of dampness, and toxic turbidity accumulates in the skin; prolonged illness affects the kidney and invades the collaterals, resulting in a stubborn combination of toxin and blood stasis that is difficult to resolve. Based on this understanding, a stage-based differentiation and treatment plan is established: In the early stage, the treatment focuses on soothing the liver and regulating qi to expel pathogenic factors, clearing heat and removing toxins to protect the skin; in the middle stage, the emphasis is on soothing the liver and invigorating the spleen to resolve turbidity, removing toxins and draining dampness to harmonize the Ying-nutrients and Wei-defence; in the late stage, the treatment aims to tonify the kidney and replenish essence to strengthen the foundation, activate blood and unblock the collaterals to eliminate latent toxins. This study aims to provide new ideas and theoretical evidence for the prevention and treatment of skin adverse reactions related to targeted therapy drugs using TCM. |
| Key words: tumor skin adverse reactions related to targeted therapeutic drugs one body with two wings regulating and harmonizing qi movement Chinese medicines ZHANG Zhen |
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