从五脏一体观探讨瑞戈非尼所致腹泻

Discussion on diarrhea caused by regofenib from the perspective of five internal organs

瑞戈非尼作为一种多靶点抗肿瘤药物,在治疗转移性结直肠癌、肝细胞癌及胃肠道间质瘤等方面获得疗效的同时,其较常见不良反应腹泻,极大影响了患者生活质量及预后。诸多医家认为腹泻的病机主要为脾虚湿盛,治以健脾化湿为主。而瑞戈非尼所致腹泻,病机复杂,不仅存在脾虚它脏亦常受病,宜从中医五脏一体观出发,整体辨治。五脏作为一个整体,之间相互联系与协助,共同维持人体生命活动。肝主疏泄、调畅人体气机,心主血、鼓舞一身阳气,肺主治节、调节人体水液,肾主封藏、内有真阴真阳,其他四脏的功能异常,都会影响到脾主运化,主升清的功能,从而影响体内水液生成、运行与排泄,以致湿浊内生而成泄泻。因此,治疗瑞戈非尼所致腹泻应立足五脏一体观,辨脏论治,协调共治,而非仅从脾论治。

As a multi-target anti-tumor drug,regofenib is effective in the treatment of metastatic colorectal cancer,hepatocellular carcinoma and gastrointestinal stromal tumor,and its common side effect is diarrhea,which greatly affects the quality of life and prognosis of patients.Many medical experts believe that the pathogenesis of diarrhea is mainly spleen deficiency and dampness,and the main treatment is to dispelling spleen dampness.However,the diarrhea caused by regofenib has a complicated pathogenesis,which not only exists in spleen deficiency but also often suffers from the viscera.As a whole,the five internal organs are connected and assisted to maintain human life activities together.Liver qi regulates the human body,heart blood inspires the spirit,lung adjusts the body fluid,kidney governs storage,the dysfunction of four other organs will affect the spleen,which in turns affects the body fluid generation,operation and discharge,which leads to the endogenous dampness and diarrhea.Therefore,the treatment of diarrhea caused by regofenib should be based on the concept of five internal organs as a whole,the differentiation of internal organs and the coordination of treatment,rather than just from the spleen.