乌梅丸治疗肿瘤免疫疗法相关肠炎探析

Wumei Pill in the treatment of tumor immunotherapy related colitis

恶性肿瘤免疫疗法是热门的肿瘤治疗手段,但其诱发的免疫相关肠炎等不良反应,不仅影响肿瘤治疗,还降低了肿瘤患者生活质量。经方乌梅丸治疗免疫相关肠炎有一定临床疗效。虚实夹杂、寒热错杂是免疫疗法相关肠炎的病机特点,乌梅丸可应用于寒热错杂之病。免疫疗法相关肠炎属厥阴病,乌梅丸是《伤寒论》厥阴病篇首方。脏寒是免疫疗法相关肠炎主要病因,乌梅丸是主治寒热夹杂下利的基本方和重要方。乌梅丸全方通过相须、相使和相反配伍,酸收御风、辛热扶阳、酸苦坚阴、寒热并用、敛补温清、攻补兼并,共同达到补益不留邪、清热不伤正的治疗目的,治疗免疫疗法相关肠炎疗效显著。乌梅丸重用味酸之药,并与少量寒热药物并用,重在调整阴阳。补药与泻药同用,兼顾正气。

Immunotherapy for malignant tumors is a hot issue in the field of tumor treatment, but its adverse reactions such as immune associated colitis not only affect tumor treatment, but also reduce the life quality of patients. Wumei Pill is of certain clinical effects on immunotherapy related enteritis. The pathogenesis of immunotherapy related colitis is characterized by the deficiency and excess complex, as well as intermingled cold and heat while Wumei Pill can be applied to the disease of intermingled cold and heat. Immunotherapy related colitis belongs to Jueyin diseases while Wumei Pill is the first choice for Jueyin diseases recorded in Treatise on Cold Damage. Visceral cold is the main cause of immunotherapy related colitis, and Wumei Pill is the basic and important prescription indicated for the diarrhea of cold and heat. The whole prescription of Wumei Pill can achieve the therapeutic purpose of tonifying with no pathogenic factors left and clearing away heat without injuring the healthy Qi. Wumei Pill can resist the wind by the sour agents, strengthen Yang with heat herbs, and enrich Yin with herbs of bitter and sour. Moreover, it integrates the methods of warming and clearing, attacking and reinforcing, with remarkable therapeutic effects for immunotherapy related enteritis. Wumei Pill uses sour medicine in great quantity, together with a small amount of cold and heat drugs, to regulate Yin and Yang. Tonic and cathartic are used simultaneously, with care to healthy Qi.