从“玄府-肺络”论治肺癌靶向治疗后皮肤瘙痒症经验

Experience in differentiating and treating skin pruritus after a targeted treatment of lung cancer based on the"Xuanfu-lung collaterals"theory

总结基于“玄府-肺络”系统辨证治疗肺癌靶向治疗后皮肤瘙痒症的经验思路。玄府为肺络之枢纽门户,肺络为玄府之濡养通路,二者充肌表,联脏腑,相附依存。结合肺癌靶向治疗后皮肤瘙痒症的临床特点为皮疹、皮肤瘙痒、干燥等,提出其核心病机为玄府郁闭,肺络瘀虚。以久病虚实夹杂,脏腑阴阳气血失调,久病多瘀入络,络虚不荣,玄府郁闭为病机特点。临证时谨守病机,分期论治,内外并治,以开玄通络为基本治则,治以宣散开玄透邪、祛瘀荣络固本,可获良效。

This papers means to summarize the experience and thinking of differentiating and treating skin pruritus after a targeted treatment of lung cancer based on the"Xuanfu-lung collaterals"system.Xuanfu are the gateways to the lung collaterals while the lung collaterals are the nourishing pathways of Xuanfu,both of which nourish the muscle surfaces,link the zang-fu viscera and are interdependent.Combined with the clinical characteristics of skin pruritus after a targeted treatment of lung cancer,which are characterized by rash,skin pruritus,dryness and so on,it is proposed that its core pathogeneses are the depressed-stagnant Xuanfu and static-deficient pulmonary collaterals,and its pathogenesis is characterized by the intermingled deficiency and excess due to a prolonged illness,a disorder of yin,yang,qi and blood in the zang-fu viscera,excessive stagnations entering collaterals due to a prolonged illness,the collaterals deficiency and Xuanfu stagnation.In the clinical treatment of skin pruritus after a targeted treatment of lung cancer,it is essential to adhere to its pathogenesis,to treat it by stages,and to apply a combined internal and external treatment,taking opening sweat pores and dredging collaterals as the basic treatment principle,adopting the methods of dispersing sweat pores,expelling pathogenic factors,dispelling blood stasis,nourishing collaterals and strengthening the body,with a remarkable efficacy to be expected.