基于“毒瘀骨髓”理论舒缓化疗骨髓毒性反应

Soothing Chemotherapy Bone Marrow Toxicity Response Based on the Theory of "Duyu Gusui"

化疗药可导致造血干细胞耗竭及骨髓微环境紊乱,产生骨髓毒性反应。陈信义教授为主的学术团队在长期的临床实践中提出,“毒瘀骨髓”是化疗骨髓毒性反应的关键病机。本文从化疗药毒直中骨髓,毒聚骨髓不得逾越而成瘀和毒瘀骨髓新血不得生化的角度来阐述化疗导致“毒瘀骨髓”的理论基础;基于“毒瘀骨髓”理论,详细论述从祛髓瘀、通髓络、生髓血、生髓络等方面,应用祛瘀生新法指导临床以达到化生新血、改善骨髓造血功能、舒缓骨髓毒性反应的目的。“毒瘀骨髓”学说的建立可以弥补许多文献对化疗骨髓毒性反应源于脾肾亏虚、气血不足的血液学损害观点的不足,丰富了中医对化疗药导致骨髓毒性反应的认识,并可指导用药,多层面舒缓骨髓毒性反应,在临床上具有重要价值。

Chemotherapeutics can lead to exhaustion of hematopoietic stem cells and disturbance of bone marrow microenvironment ,resulting in bone marrow toxicity response. Professor Chen Xinyi's academic team has put forward that " Duyu Gusui " is the key pathogenesis of bone marrow toxicity response induced by chemotherapy in long-term clinical practice. This article elaborates the theoretical basis of " Duyu Gusui " caused by chemotherapy from the point of view that chemotherapy drugs directly invade the bone marrow, poison accumulating in bone marrow can not be overstepped to become blood stasis and poison accumulating in bone marrow leads to new blood not being biochemical. Based on the theory of " Duyu Gusui ", this paper elaborates on the application of " Quyu Shengxin method " to guide clinical practice from removing marrow stasis and removing obstruction in marrow collaterals ,generating marrow blood and generating marrow collaterals to achieve the purpose of removing blood stasis and generating new blood, improving hematopoietic function of bone marrow and alleviating toxic reaction of bone marrow. The establishment of the theory of " Duyu Gusui " can make up for the consensus of many literatures that the bone marrow toxicity response caused by chemotherapy originates from the hematological damage of spleen and kidney deficiency and insufficiency of qi and blood. It enriches the understanding of the bone marrow toxicity response caused by chemotherapeutic drugs in traditional Chinese medicine and can guide the use of drugs and alleviate the bone marrow toxicity response in many aspects. It has important clinical value.