《血证论》对肿瘤化疗后骨髓抑制的论治

“Blood Syndrome Theory”on the Treatment of Bone Marrow Suppression after Tumor Chemotherapy

唐宗海为晚清著名医家,其著作《血证论》阐述了中医血证的基础理论及临床治法方药,《血证论》中的第一卷六条总论就血证机理进行了详细论述,其中阐述的水火为气血生化之源、去瘀生新法、调和五脏阴阳以生血、补血亦有宜有忌等理论对于临床气血生化不足之证有着重要的指导价值。现代肿瘤化疗后的骨髓抑制在中医范畴内辩证属“血证”、“血虚病”、“虚劳病”[1],其中医证型多以气血阳虚证为主,且夹杂痰湿、火热、寒邪与瘀血等病邪[2],在临床上西医虽有一定疗效,但费用较昂贵,且毒副作用较多,该文从《血证论》入手,分析探讨其对现代化疗药物所致的骨髓抑制的认识并例举部分治法方药及思想特色,旨在为临床诊治开拓新的思路和方法。

TANG Zonghai was a famous doctor in the late Qing Dynasty.His book“Blood Syndrome Theory”elaborated the basic theory and clinical treatment methods and prescriptions of blood syndrome in traditional Chinese medicine.The six general theories in the first volume of“Blood Syndrome Theory”discussed the mechanism of blood syndrome in detail.The theories elaborated therein include water and fire as the source of Qi and blood biochemistry,removing blood stasis and generating new methods,harmonizing yin and yang of the five zang-organs to generate blood,enriching blood and having taboos have important guiding value for clinical qi and blood biochemical deficiency.Bone marrow suppression after modern tumor chemotherapy is dialectically classified as“blood syndrome”,“blood deficiency disease”and“deficiency disease”in the scope of traditional Chinese medicine.Its traditional Chinese medicine syndrome types are mostly Qi and blood yang deficiency syndrome,and are mixed with phlegm-dampness,heat,cold pathogenic factors and blood stasis and other pathogenic factors.Although western medicine has certain curative effects in clinical practice,it is expensive and has many toxic and side effects.This article starts with“Blood Syndrome Theory”to analyze and discuss its Recognition of bone marrow suppression caused by modern chemotherapy drugs and examples of some treatment methods,prescriptions and ideological characteristics,aiming to open up new ideas and methods for clinical diagnosis and treatment.