基于填精益卫治疗原则对化疗后骨髓抑制标靶辨治临床诊疗及用药思考

Clinical diagnosis,treatment,and medication considerations for targeted differentiation and treatment of bone marrow suppression after chemotherapy based on the principle of replenishing essence and supplementing defensive qi

骨髓抑制是化疗后常见一类副反应,其中以白细胞减少最常见。本文根据对白细胞与卫气相关性的论述,指出卫气与肾有着密切的关系,补卫气有助于白细胞计数提升,对化疗后骨髓抑制局部辨证,应以填精益卫为治疗原则。结合仝小林院士态靶辨治中标靶辨治理论,在局部填精益卫原则基础上,借鉴中药药理学选取能够提升白细胞数目的中药,标靶辨治,以期为化疗后骨髓抑制中医宏观辨证提供新的诊疗思路,进行态靶辩治,提升临床治疗效果。

Bone marrow suppression is a common side effect after chemotherapy,and leukopenia is the most frequently seen symptom.This article discusses the relationship between white blood cells and defensive qi,and proposes that defensive qi is closely connected to the kidney.By supplementing defensive qi,it can help increase the white blood cell count.Based on these two points,the article conducts a localized differentiation of symptoms and signs for leukopenia after chemotherapy.The treatment principle should focus on“replenishing essence and supplementing defensive qi,”combined with the theory of“target differentiation and treatment”by Academician Tong Xiaolin.Following the principle of“replenishing essence and supplementing defensive qi,”and drawing on the research results of TCM pharmacology,certain Chinese medicines are selected to increase the number of white blood cells for targeted differentiation and treatment.This provides new ideas for diagnosis and treatment in traditional Chinese medicine,specifically in the macroscopical differentiation treatment of bone marrow suppression after chemotherapy.The aim is to improve the effectiveness of clinical treatment through state-target differentiation and treatment.