基于“虚气留滞”探讨化疗所致周围神经病变病机及论治

Discussion on the pathogenesis and treatment of chemotherapy-induced peripheral neuropathy based on‘deficiency qi stagnation’

中医药治疗化疗所致周围神经病变尽管具有较好的临床疗效,但缺乏以病机为核心的理论指导。恶性肿瘤、化疗药物致使机体“气血阴阳失和”“脏腑精气亏虚”后的病理状态——“虚气”;痰、湿、瘀、毒等各种病理产物致使机体经络阻滞——“留滞”,二者是中医对化疗所致周围神经病变病因病机的高度概括。文章根据“虚气”和“留滞”二者的关系对疾病的动态病机演变进行探讨,提出化疗所致周围神经病变的“虚气留滞”病机,总结其论治思路重点在于“培元补虚、开郁行滞”。以期为化疗所致周围神经病变提供新的临床治疗思路,丰富并发展中医相关理论。

Although traditional Chinese medicine(TCM)has good clinical effects in the treatment of chemotherapyinduced peripheral neuropathy(CIPN),it lacks the theoretical guidance with pathogenesis as the core.The pathological state of the body after malignant tumors and chemotherapy drugs caused the body to‘disharmony of qi and blood,yin and yang’,and‘deficiency of Zangfu’s pneuma’:‘Deficiency-qi’;Various pathological products,such as phlegm,dampness,blood stasis,and toxins,cause the meridian blockage:‘Stagnation’.The two are a high-level summary of the etiology and pathogenesis of CIPN in TCM.Based on the relationship between‘deficiency-qi’and‘stagnation’,the article discusses the dynamic pathogenesis of the disease and proposes the pathogenesis of‘deficiency-qi stagnation’on CIPN,it is concluded that the key point of the train of thought of its theory and treatment is‘restoring deficiency and cultivating yuan qi,opening depression and moving stagnation’.To provide new clinical treatment ideas for CIPN and enrich and develop the relevant theories of TCM.