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张雯,周锦勇,壮雨雯,王松玲,彭海燕.基于肺肠同调辨治结直肠癌化疗后手足综合征[J].湖南中医药大学学报,,():[点击复制] |
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| 基于肺肠同调辨治结直肠癌化疗后手足综合征 |
| 张雯,周锦勇,壮雨雯,王松玲,彭海燕 |
| (南京中医药大学, 江苏 南京 210029;南京中医药大学附属医院, 江苏 南京 210029) |
| 摘要: |
| 结直肠癌化疗后手足综合征(HFS)是化疗药物所致的常见皮肤毒性反应之一。“肺与大肠相表里”理论认为，肺与大肠经脉相互络属，气血相通，病理状态下两者亦可相互传变。结直肠癌患者脏腑本虚，癌毒先伤大肠，致肠腑受损，化疗药毒乘虚攻伐，使肠损益甚，浊邪内蕴为发病之源；肠腑浊毒上逆犯肺，肺失治节，枢机不利为传变之枢；腑实脏虚，肺气郁闭，宣发失司，皮毛失养，湿热毒邪壅滞络脉，外达四肢末端，发为 HFS。法当肺肠同调：内治以健脾润肠、宣肺通络，方选自拟养肺清肠解毒汤；外治以透皮达络、疏经通滞，方选清肺解毒通络方浸洗；并重视形神共养、固护轴本，方选自拟五花解郁饮化裁。附验案一则以佐证。 |
| 关键词: 结直肠癌 化疗 手足综合征 病机 肺肠同调 形神共养 |
| DOI： |
| 投稿时间：2026-03-18 |
| 基金项目:国家自然科学基金项目(82574825)；江苏省自然科学基金项目(BK20241995)；国家中医药管理局全国名中医刘沈林工作室项目(国中医药办人教函[2018]119 号)。 |
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| Treating hand-foot syndrome after chemotherapy for colorectal cancer based on the lung-intestine co-regulation theory |
| ZHANG Wen,ZHOU Jinyong,ZHUANG Yuwen,WANG Songling,PENG Haiyan |
| (Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, China;The Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, China) |
| Abstract: |
| Hand-foot syndrome (HFS) after chemotherapy for colorectal cancer is one of the common cutaneous toxic reactions caused by chemotherapeutic agents. According to the theory that "the lung and the large intestine are interior-exteriorly related," the meridians of the lung and the large intestine are interconnected and mutually affiliated, with free communication of qi and blood, and under pathological conditions the two can also mutually transmit and transform. In patients with colorectal cancer, the zang-fu organs are inherently deficient; cancer toxin first damages the large intestine, leading to impairment of the intestinal fu-organs. Chemotherapeutic drug toxicity, taking advantage of this deficiency, attacks and further damages the intestine, causing internal accumulation of turbid pathogenic factors, which serves as the source of the disease. Turbid toxin from the intestinal fu-organs rebels upward and attacks the lung; the lung loses its function of governing management and regulation, and impairment of the pivot mechanism serves as the pivot of transmission and transformation. With fu-organ excess and zang-organ deficiency, lung qi becomes depressed and obstructed, diffusion and dispersion are impaired, the skin and hair lose nourishment, and damp-heat toxin stagnates in the collaterals, extending outward to the extremities, thus manifesting as HFS. The treatment method should be simultaneous regulation of the lung and intestine: for internal treatment, invigorating the spleen and moistening the intestine, diffusing the lung and unblocking the collaterals, with the self-formulated Yangfei Qingchang Jiedu Decoction selected; for external treatment, penetrating the skin and reaching the collaterals, dredging the meridians and resolving stagnation, with Qingfei Jiedu Tongluo Formula for soaking and washing selected; and attention should also be paid to simultaneously nourishing both body and spirit and protecting the axial root, with modified self-formulated Wuhua Jieyu Drink selected. A verified medical record is attached as supporting evidence. |
| Key words: colorectal cancer chemotherapy hand-foot syndrome pathogenesis lung-intestine co-regulation nourishing both body and spirit |
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