李凫坚治疗抗痨药物导致白细胞减少症的临床经验

Clinical Experience in Li Fujian's Treating Chemotherapy Drugs-caused Leukopenia

[目的]本文从气血不足的角度探讨抗痨药物导致的白细胞减少症的诊治要点以及中医药治疗本病的思路。[方法]白细胞减少症是抗痨药物导致的常见副作用之一。本文从本病的病因、临床表现、发病特点、辨证要点以及疗效和预后出发,以益气健脾补血为法,观察对2.5×109/L^3.0×109/L及3.0×109/L^4.0×109/L不同范围的白细胞减少症患者的疗效,确立以气血亏虚为其主要发病机理,从而提出更为有效的治疗方法。[结果]以补气养血为法,在常规升白细胞治疗方案中加用以八珍汤为主方加减的中药治疗后,不同程度病情的患者外周血白细胞均可迅速升至正常。[结论]益气健脾补血法对于本病具有良好的疗效,具有进一步研究指导临床的意义,对于抗结核治疗的顺利施行具有良好的辅助作用。

[Objective] To discuss the diagnosis and treatment points of leukopenia induced by themotherapy drugs from the angle of deficient Qi and blood and the thought of TCM therapy. [Method] The leukopenia is one of the common sides effects of chemotherapy; the article observes the cure effects on leukopenia patients in different ranges of 2.5 ＆#215;109/L^3.0 ＆#215;109/L and 3.0 ＆#215;109/L^4.0 ＆#215;109/L, with the method of tonifying Qi, reinforcing spleen and nourishing blood, starting from causa morbi, clinical demonstrations, morbidity features, differentiation points, cure effect and prognosis, to define that deficient Qi and blood is the main pathogenesis, therefore puts forward more effective therapy. [Result] With the method of tonifying Qi and nourishing blood, adding Bazhen Decoction to the plan of raising leukocyte, the patients of different degrees of disease al have normal peripheral cells. [Conclusion] The method of tonifying Qi reinforcing spleen and nourishing blood has good cure effect on the disease above, with further meaning of guding clinic and good coordinating function to smoothen treatment of anti-tuberculosis.