| 引用本文: |
郑程玉龙, 贺佳雨, 闫理想, 陈猛, 张莹, 史哲新.史哲新基于“髓毒犯肝”理论治疗骨髓增殖性肿瘤经验[J].湖南中医药大学学报,2026,46(8):1610-1617[点击复制] |
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| 史哲新基于“髓毒犯肝”理论治疗骨髓增殖性肿瘤经验 |
| 郑程玉龙,贺佳雨,闫理想,陈猛,张莹,史哲新 |
| (天津中医药大学第一附属医院, 天津 300381;中医国家临床医学研究中心, 天津 300381) |
| 摘要: |
| 骨髓增殖性肿瘤（MPN）是起源于造血干细胞的恶性克隆性疾病。史哲新教授在继承“虚、毒、瘀”病机理论及“清肝化瘀”治法的基础上，结合MPN克隆性造血的病理本质，提出“髓毒犯肝，肾为枢机”的核心病机理论。该理论以肝为核心病位、肾为传变枢纽，阐释髓毒循“髓-肾-肝”轴传变的病理过程，并据此构建分期论治体系，确立清肝透毒、补肾填髓、化痰逐瘀、虫类搜剔四法并行的用药思路，同时将微观指标纳入辨证，配合全程调护。本文系统梳理该理论的构建脉络、核心内涵及其临床指导价值。 |
| 关键词: 骨髓增殖性肿瘤|髓毒犯肝|肾为枢机|分期论治|名医经验|史哲新 |
| DOI：10.3969/j.issn.1674-070X.2026.08.010 |
| 投稿时间：2025-10-17 |
| 基金项目:国家自然科学基金委员会青年科学基金项目（82104785）；天津市名中医传承工作室建设项目（tjmzy2406）。 |
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| SHI Zhexin's experience in treating myeloproliferative neoplasms based on the theory of “marrow toxin invading the liver” |
| ZHENG Chengyulong, HE Jiayu, YAN Lixiang, CHEN Meng, ZHANG Ying, SHI Zhexin |
| (First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300381, China;National Clinical Research Center for Chinese Medicine, Tianjin 300381, China) |
| Abstract: |
| Myeloproliferative neoplasms (MPN) are malignant clonal disorders originating from hematopoietic stem cells. On the basis of inheriting the pathogenesis theory of "deficiency, toxin, and stasis" and the therapeutic principle of "clearing the liver and transforming stasis" and taking into account the pathological nature of clonal hematopoiesis in MPN, Professor SHI Zhexin proposes the core pathogenesis theory of "marrow toxin invading the liver, with the kidney as the pivot". This theory takes the liver as the core diseased location and the kidney as the pivot for pathological transmission, and elucidates the pathological process whereby marrow toxin transmits along the "marrow-kidney-liver" axis. Based on this, a system of treatment according to disease stage is established, together with a medication strategy integrating four therapeutic methods: clearing the liver and expelling toxin, tonifying the kidney and replenishing marrow, transforming phlegm and stasis, and using insect-derived medicines to scour and eliminate pathogens. Meanwhile, micro-indicators are incorporated into pattern identification together with comprehensive care throughout the course of treatment. This article systematically reviews the development, core concepts, and clinical guiding value of this theory. |
| Key words: myeloproliferative neoplasms|marrow toxin invading the liver|kidney as the pivot|stage-based treatment|famous physician's experience|SHI Zhexin |
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