| 引用本文: |
张思佳, 过颖颖, 唐晓龙.基于“寒毒内伏”病机理论探讨奥沙利铂毒副作用的中医药防治策略[J].湖南中医药大学学报,2025,45(9):1729-1733[点击复制] |
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| 基于“寒毒内伏”病机理论探讨奥沙利铂毒副作用的中医药防治策略 |
| 张思佳,过颖颖,唐晓龙 |
| (苏州市中西医结合医院, 江苏 苏州 215100) |
| 摘要: |
| 基于“寒毒内伏”病机理论系统阐述奥沙利铂毒副作用的统一病理机制，并总结其指导下的中医药干预策略。通过归纳其临床常见的周围神经病变、消化道反应及骨髓抑制症状，提出该类症状的病机分别为：寒毒伏络、痹阻经脉，寒毒客脾、脾阳受损，寒毒伏髓、元阳衰微。在治疗上，强调运用温阳散寒、益气活血、健脾和胃、温肾填精等治法，常用方剂包括黄芪桂枝五物汤、补中益气汤、阳和汤及其衍生方，并辅以针灸、热敷等中医外治法。研究表明，此类治法有助于改善奥沙利铂所致的毒副作用，提高患者耐受性与生活质量。本文明确了“寒毒内伏”为奥沙利铂毒副作用的核心病机，提出以温阳解毒为核心的治疗思路，为后续临床与实验研究提供了理论依据。 |
| 关键词: 寒毒内伏 奥沙利铂 毒副作用 温阳解毒 周围神经病变 消化道反应 骨髓抑制 |
| DOI：10.3969/j.issn.1674-070X.2025.09.020 |
| 投稿时间：2025-07-14 |
| 基金项目:吴中区科技局指导性项目(WKJ2022005); 江苏省中医药学会科研项目(ZXFZ2024068); 苏州市科技计划发展指导性项目(SKYXD2022073)。 |
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| Managing oxaliplatin-induced toxicities with Chinese medicine based on the “latent cold toxin” theory |
| ZHANG Sijia, GUO Yingying, TANG Xiaolong |
| (Suzhou Hospital of Integrated Traditional Chinese and Western Medicine, Suzhou, Jiangsu 215100, China) |
| Abstract: |
| This paper expounds the unified pathogenesis of oxaliplatin-induced toxicities based on the Chinese Medicine（CM） theory of "latent cold toxin," and summarizes corresponding CM interventions. Its common clinical manifestations such as peripheral neuropathy, gastrointestinal reactions, and myelosuppression are summarized, and the pathogenesis of these manifestations is proposed to be cold toxin lying latent in the collaterals and blocking the meridians, cold toxin invading the spleen and impairing the spleen yang, and latent cold toxin in the marrow exhausting primordial yang, respectively. Therapeutic strategies emphasize warming yang and dissipating cold, supplementing qi and circulating blood, strengthening the spleen and harmonizing the stomach,and warming the kidney and replenishing essence. Commonly used formulas include Huangqi Guizhi Wuwu Decoction, Buzhong Yiqi Decoction, Yanghe Decoction, and their modified formulas, complemented by external CM therapies such as acupuncture,moxibustion, and warm compresses. Studies indicate that these approaches help alleviate oxaliplatin-induced toxicities and improve patients’ tolerance and quality of life. This paper clarifies that "latent cold toxin" is the core pathogenesis of oxaliplatin-induced toxicities, proposes a treatment strategy centered on warming yang and detoxification, and provides a theoretical basis for subsequent clinical and experimental research. |
| Key words: latent cold toxin oxaliplatin toxicities warming yang and detoxification peripheral neuropathy gastrointestinal reactions myelosuppression |
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