“干湿”辨证治疗抗肿瘤药物致手足皮肤不良反应

Treatment of Hand and Foot Skin Adverse Reactions Caused by Anticancer Drugs Based on Syndrome Differentiation of“Dryness and Dampness”

抗肿瘤药物易使患者出现手足皮肤不良反应,严重影响生活质量,甚至影响化疗剂量或疗程,进而影响治疗效果。目前没有统一的治疗标准,西医主要采取大剂量维生素B6,COX-2抑制剂塞来昔布、糖皮质激素、尿素乳膏等,疗效不佳。通过查阅古籍及文献,手足皮肤不良反应属于"浸淫疮"、"指疔"、"鹅掌风""、瘑疮"范畴,并整理相关外治常用药,我们认为应根据皮损的不同临床表现辨证治疗。最终,将手足皮肤不良反应辨为气滞血瘀证、湿热热毒证、血虚风燥证、瘀毒阻滞证,在此基础上,分为"干性""、湿性",应用于临床治疗,初步取得较好疗效。

Hand and foot skin adverse reactions that caused by anticancer drugs,seriously affect the quality of life and even change the dose or interrupt treatment so that it can affect the effectiveness of treatment in serious cases.However,there is no unified treatment standard for this.The current treatments of Western medicine mainly rely on high-dose vitamin B6,cox-2 inhibitor celixib,glucocorticoid,urea cream,etc.But they have showed poor performance.By consulting classics of traditional Chinese medicine and literatures,the skin adverse reactions belong to"general effused eczema","pustule of fingertip","tinea manuum"and"palmoplantar pustulosis".We also organized related external treatment experience,and we thought the traditional Chinese medicine(TCM)therapies based on syndrome differentiation should be taken for different clinical manifestations of skin.Finally,we divided hand and foot skin adverse reactions into 4 TCM syndrome types,which were qi stagnation and blood stasis syndrome,dampness heat toxin syndrome,blood deficiency and wind dryness syndrome,and blood stasis and toxin stagnation syndrome.On this basis,it is divided into"dryness"and"dampness".It has been applied to clinical treatment and initially achieved good results.