1.中国中医科学院广安门医院 北京 100053
2.北京中医药大学研究生院
韩莹莹,女,在读博士生
# 李杰,男,博士,教授,主任医师,博士生导师,主要研究方向:中药干预肿瘤复发转移,E-mail:drjieli2007@126.com
纸质出版日期:2023-11-30,
网络出版日期:2023-10-27,
收稿日期:2023-06-12,
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韩莹莹, 李杰, 朱广辉, 等. 从阳微阴弦论治肿瘤化学治疗相关心脏毒性[J]. 北京中医药大学学报, 2023,46(11):1623-1628.
HAN Yingying, LI Jie, ZHU Guanghui, et al. Treatment of cardiac toxicity due to chemotherapy based on the theory of weak pulse at yang and wiry pulse at yin[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(11):1623-1628.
韩莹莹, 李杰, 朱广辉, 等. 从阳微阴弦论治肿瘤化学治疗相关心脏毒性[J]. 北京中医药大学学报, 2023,46(11):1623-1628. DOI: 10.3969/j.issn.1006-2157.2023.11.020.
HAN Yingying, LI Jie, ZHU Guanghui, et al. Treatment of cardiac toxicity due to chemotherapy based on the theory of weak pulse at yang and wiry pulse at yin[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(11):1623-1628. DOI: 10.3969/j.issn.1006-2157.2023.11.020.
阳微阴弦是《金匮要略》对胸痹病因病机的阐释。在肿瘤的治疗过程中,化学治疗(简称“化疗”)产生的心脏毒性可归属于中医学“胸痹”范畴,阳微阴弦对心脏毒性的发生、发展、转归及治疗有重要指导意义。肿瘤患者因病而虚、因药致虚的阳微之本是化疗心脏毒性发生的基本病机,痰浊、血瘀、药毒等阴弦标实是其发作或加重的病理基础。化疗期间,依据患者机体“阳气尚足—阳气渐虚—阳气衰败”及“阴弦不盛—阴弦渐盛—阳衰阴盛”等特点分析不同阶段心脏毒性的病机及临床特点,并以此提出以益气健脾防病生、祛痰化瘀阻其变、温阳利水培其本等治法分阶段论治,以期为中医药在化疗心脏毒性的防治中提供借鉴。
The traditional Chinese medicine (TCM) theory of weak pulse at yang and wiry pulse at yin in the
Synopsis of the Golden Chamber
is used to explain the etiology and pathogenesis of chest
bi
or chest painful impediment. Cardiac toxicity due to chemotherapy belongs to the TCM category of "chest
bi
". Thus
it is believed that the theory of
Yang Wei Yin Xian
can provide guidance in the occurrence
development
prognosis
and treatment of this complication. The basic pathogenesis of chemotherapy-induced cardiac toxicity is the deficiency of yang in tumor patients caused by illness and medication. Turbid phlegm
blood stasis
and drug toxicity are the pathological basis for cardiac toxicity occurrence or exacerbation. During chemotherapy
the pathogenesis and clinical characteristics of cardiac toxicity at different stages are analyzed based on the characteristics of the patients
which includes the steps "exuberance of yang
gradual deficiency of yang
decline of yang" and "insufficiency of yin pathogen
different gradually exuberance of yin pathogen
yang deficiency and yin excess". Different treatment method in phases are proposed according to these characteristics
such as supplementing qi and strengthening the spleen to prevent disease
dispelling phlegm and resolving stasis against disease changes
and warming yang and promoting urination to improve vital qi. This study provides a reference for TCM in the prevention and treatment of chemotherapy-induced cardiac toxicity.
心脏毒性化学治疗不良反应金匮要略阳微阴弦
cardiac toxicitychemotherapyadverse reactionsSynopsis of the Golden Chamberweak pulse at yang and wiry pulse at yin
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