手足皮肤不良反应的中医辨治思路探析

Syndrome differentiation and treatment of hand-foot skin reaction in traditional Chinese medicine

手足皮肤不良反应(HFS/HFSR)是抗肿瘤药物常见的皮肤毒性反应,影响患者抗肿瘤治疗进程和日常生活质量。中医学认为手足皮肤不良反应属于“窩疮”“浸淫疮”“血痹”等范畴,通过临床观察及查阅古籍、医案,手足皮肤不良反应根据不同的临床症状辨证,可分为气滞血瘀、热毒瘀积、血虚风燥、阳虚血瘀四个证型。论述手足皮肤不良反应的中医病因病机及辨治思路,予内服外治治疗,可取得较好的疗效。

Hand-foot syndrome/hand-foot skin reaction(HFS/HFSR)is a common skin toxicity reaction of antitumor drugs.In traditional Chinese medicine(TCM),HFS/HFSR falls into the categories of"cellular furuncle","general effused eczema",and"blood obstruction",etc.Through clinical observation,reviewing ancient books and medical cases,this study classifies HFS/HFSR into four TCM syndrome patterns according to its different clinical symptoms:syndrome of qi stagnation and blood stasis,syndrome of heat-toxicity with blood stasis,syndrome of blood deficiency and wind-dryness and syndrome of yang deficiency and blood stasis,exploring the etiology,pathogenesis,syndrome differentiation and treatment ideas of HFS/HFSR in traditional Chinese medicine.It is argued that the disease can be treated by administering combined internal and external treatment to achieve a good preliminary curative effect.