乳腺癌化疗后重度骨髓抑制的三节点防治

Three-Node Prevention and Treatment of Severe Bone Marrow Suppression after Breast Cancer Chemotherapy

以"未病先防、已病早治、愈后防复"三阶段核心思想,结合重度骨髓抑制的3个关键节点,建立乳腺癌化疗后重度骨髓抑制的防治体系。第一节点(欲下降节点):未病先防治其先,即患者入院当日检查无异常后按既定方案开始化疗,化疗后第1天观察患者不良反应,必要时对症处理,方用温肾健脾自拟方足浴;第二节点(低峰前节点):已病早治防其变,以中医药治疗为主,健脾益气补血,以扶助机体对骨髓抑制的抵抗力,方用补中益气汤;第三节点(恢复期节点):愈后调治防其复,此时病机多为邪气未尽、正气已虚,此阶段是发挥中医优势的最佳时期,治疗上宜健脾补肾扶正,以填精补髓、益气养血为法,方选归脾汤合龟鹿二仙汤加味。

Based on the three-stage core idea of"prevention before disease,early treatment after disease,prevention after recovery",combined with the three key nodes of severe myelosuppression,the prevention and treatment system of severe myelosuppression after breast cancer chemotherapy was established.The first node(to drop node):prevention and treatment first,that is,the patient will start chemotherapy according to the established plan after the examination on the day of admission,observe the adverse reactions of the patients on the first day after chemotherapy,and treat the disease if necessary.The self prepared prescription can be used to warm kidney and invigorate spleen by foot bath.The second node(the node before the low peak):the disease has been treated early to prevent its change,mainly treated with Chinese medicine,strengthening the spleen,replenishing qi and blood,in order to help the body′s resistance to bone marrow suppression.Buzhong Yiqi Decoction can be used.The third node(recovery period node):after the disease is cured,it is necessary to regulate and treat to prevent the recurrence of the disease.At this time,the pathogenesis is mostly that the pathogenic qi is not eliminated,and the healthy qi has been damaged.This stage is the best time to give full play to the advantages of Chinese medicine.The treatment should focus on strengthening the spleen,tonifying the kidney and strengthening the body.The method is to fill the essence and marrow,replenish qi and nourish blood.Guipi Decoction and Guilu Erxian Decoction are selected.