天津中医药大学第一附属医院 国家中医针灸临床医学研究中心 天津 300381
张禹成,男,在读硕士生
# 史哲新,女,博士,主任医师,教授,博士生导师,主要研究方向:中西医血液病研究,E-mail:shzhx0604@163.com
纸质出版日期:2023-10-30,
网络出版日期:2023-08-14,
收稿日期:2023-05-04,
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张禹成, 闫理想, 陈猛, 等. 从“浊邪害清”论骨髓微环境与白血病的关系及中医辨治[J]. 北京中医药大学学报, 2023,46(10):1467-1472.
ZHANG Yucheng, YAN Lixiang, CHEN Meng, et al. Discussion on the relationship between bone marrow microenvironment and leukemia and traditional Chinese medicine treatment based on syndrome differentiation from the perspective of "turbid evils invading the clear orifice"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(10):1467-1472.
张禹成, 闫理想, 陈猛, 等. 从“浊邪害清”论骨髓微环境与白血病的关系及中医辨治[J]. 北京中医药大学学报, 2023,46(10):1467-1472. DOI: 10.3969/j.issn.1006-2157.2023.10.020.
ZHANG Yucheng, YAN Lixiang, CHEN Meng, et al. Discussion on the relationship between bone marrow microenvironment and leukemia and traditional Chinese medicine treatment based on syndrome differentiation from the perspective of "turbid evils invading the clear orifice"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(10):1467-1472. DOI: 10.3969/j.issn.1006-2157.2023.10.020.
骨髓微环境与人体造血功能调控密切相关。研究发现,白血病干细胞对骨髓微环境的损伤、破坏和羁留与白血病的发病、耐药及微小残留等病理过程密切相关。本文通过探讨中医学“浊邪害清”理论,结合现代研究拓展“浊”“清”之内涵,认为白血病由正虚髓弱、浊侵清髓所致,并由此进一步形成髓邪外发、清髓留浊的病机,从“浊邪害清”思路逆向确立以扶正解毒还清为主旨的白血病中医辨治原则,在扶正培本治疗基础上序贯解毒、清髓、和解的诊疗思路,以期清除在髓之邪。中医药在白血病全流程治疗中均每见良效,但具体作用机制尚未明确,仍需更多的临床及基础研究以确立并扩大中医药的独特优势。
The proper functioning of the human hematopoietic system is closely regulated by the bone marrow microenvironment. The destruction and injury of the bone marrow microenvironment by leukemia stem cells are closely related to the attack
drug resistance
and additional pathological processes of leukemia. This article explores the traditional Chinese medicine (TCM) theory of "turbid evils invading the clear orifice" and further expands the meaning of "turbid" and "clear". According to TCM
the deficiency of healthy qi causing the invasion of turbid evils into the clear marrow is the primary phthogenesis of leukemia. This result in the external spreading of turbid evil in the marrow
the retention of turbid pathogen in the clear marrow
and other pathogenic factors. Based on the above theory
the principle of TCM differentiation and treatment for leukemia should focus on reinforcing healthy qi
resolving toxins and restoring the clear orifice. To remove the evil from the marrow
treatment should involve detoxification
marrow clearance
and harmonization method
while also reinforcing healthy qi to restore the normal function. TCM has shown good effects throughout the entire process of leukemia treatment
but more clinical and basic research is still needed to establish and expand the unique advantages of TCM.
白血病浊邪害清骨髓微环境浊邪
leukemiaturbid evils invading the clear orificebone marrow microenvironmentturbid evils
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