从治未病角度探讨造血系统辐射损伤的防治

Prevention and treatment of radiation-induced hematopoietic system injury from the perspective of treating disease before its onset

造血系统对射线极为敏感,其损伤的轻重和恢复的快慢在很大程度上影响放射病的发展和预后。治未病理论是中医预防医学思想的高度概括和总结,其未病先防、既病防变、瘥后防复的分阶段防治理论,对有效减轻辐射对造血系统的损伤、降低并发症的发生、促进患者康复,有重要指导意义。我们认为,损伤前未病先防,以培养正气提高机体的抗邪能力为原则,用药以补益气血为主,佐以少量清热生津、凉血活血药;损伤后既病防变,以促进恢复、防邪深入为原则,处方时清热解毒与补益气血、填精益髓药比重相当;治愈瘥后防复,以培补正气、调理脏腑功能、促进阴阳平衡为原则,用药以补益脾胃为主,辅以养阴生津。

The hematopoietic system is extremely sensitive to radiation. Its injury severity and recovery speed play crucial roles in the development and prognosis of radiation-induced injury. The theory of＂treating disease before its onset＂（ zhi wei bing） generalizes the essence of preventive medicine in TCM,which is of great significance in effective recovery of the injury,reducing incidence of complication and speeding up healing of patients. It refers to ＂ taking various measures to prevent diseases from occurring,development or recurring＂. Before exposure to radiation,reinforcing healthy qi and resistance to pathogenic qi should be set as the principle to prevent radiation injury from occurring. Qi-and blood-tonifying herbs should be prescribed while a few heat-clearing fluid-engendering and blood-cooling blood-activating herbs could be added to assist. After radiation,in order to prevent the injury from progression,facilitate the recovery process and prevent pathogen entering the body deeper,heat-clearing toxin-removing herbs should be used in combination with qi-tonifying blood-nourishing and essence-replenishing herbs. After treatment of the radiation injury,herbs that supplement spleen and stomach shall be used as the basic herbs with yin-nourishing fluid-engendering herbs used to assist and prevent relapse,as the principle is to regulate the functions of zang-fu organs and rebalance yin-yang.