急性白血病化疗后中性粒细胞缺乏伴发热的中西医治疗进展

Progress of Traditional Chinese and Western Medicine Treatment of Febrile Neutropenia after Chemotherapy for Acute Leukemia

中性粒细胞缺乏伴发热(FN)是急性白血病(AL)患者化疗后的常见并发症,其临床表现以发热为主。因中性粒细胞缺乏易伴发感染,若不及时干预会影响急性白血病的后续抗肿瘤治疗,严重者甚至危及生命。目前AL化疗后FN的主要治疗方式包括抗菌药物初始经验性治疗、粒细胞集落刺激因子及全环境保护。中医认为,AL化疗后FN常由先天不足、后天失养、饮食劳倦、药毒所伤等因素导致,其病机为正气虚损、邪毒内侵,临床以扶正祛邪为治疗原则,应用补益气血、清热解毒类中药治疗取得良好疗效。

Febrile neutropenia(FN)is a common complication of chemotherapy in patients with acute leukemia(AL),with fever being the main clinical manifestation.Due to the lack of neutrophils,it is easy to be accompanied with infection.If not intervened in a timely manner,it can affect the subsequent anti-tumor treatment of AL,and in severe cases,even endanger life.At present,the main treatment methods for FN after AL chemotherapy include initial empirical treatment with antibiotics,granulocyte colony stimulating factor,and overall environmental protection.Traditional Chinese medicine believes that FN after AL chemotherapy is often caused by factors such as congenital deficiency,loss of nourishment after birth,improper diet and overtiredness,and drug toxicity;its pathogenesis is the deficiency of positive qi and the invasion of pathogenic toxins;the clinical treatment principle is to strengthen the body resistance to eliminate pathogenic factors,and good therapeutic effects have been achieved by using traditional Chinese medicine for tonifying qi and blood,clearing heat and detoxifying.