基于“调脾补肾”法论治化疗相关性贫血

Treatment of chemotherapy-associated anaemia based on the method of “spleen-regulating and kidney-tonifying”

关键词:  调脾补肾  化疗相关性贫血  治疗

Key words:  regulating the spleen and nourishing the kidney  chemotherapy-related anemia  treatment

摘要:

化疗相关性贫血是恶性肿瘤化学药物治疗常见的不良反应。文章探讨了“药毒”导致贫血的发病机制，早期“药毒”困阻脾胃，脾胃之气受损，病在气分，清浊相干，气不生血；晚期病及下焦肾水，真精亏耗，精不化血，血分受损，血难濡精，精血亏虚，成脾肾两虚之证。根据化疗相关性贫血疾病特点和病机的整体演变，以“调脾补肾”法为治疗总纲，早期主张调脾三法：补脾益气、运脾健气、醒脾通气，晚期注重补肾三法：填肾固精、滋肾填精、温肾养精，脾肾同调，整体强调综合辨证，多法并用，用药上灵活配伍，疗效颇佳，值得参考讨论。

Abstract:

Chemotherapy-associated anemia is a common adverse effect of chemotherapy for malignant tumors. The article discusses the pathogenesis of anemia caused by “drug poison”. In the early stage，“drug poison” obstructs the spleen and stomach，and the qi of the spleen and stomach is damaged，and the disease is in the qi，and the clear and turbid are related to each other，and the qi does not produce blood；in the late stage，the disease affects the kidney and kidney water in the lower jiao，and the loss of real essence depletes the essence，and the essence does not turn into blood，and the damage to the blood is caused by the damage of the blood，and the blood is difficult to moisten the essence. Loss of essence and blood results in deficiency of the spleen and kidney. According to the characteristics of chemotherapy-associated anemia and the overall evolution of the disease mechanism，“regulating the spleen and tonifying the kidney” is the general outline of the treatment，and in the early stage，it is advocated to regulate the spleen in three ways：tonifying the spleen and benefiting the qi，transporting the spleen and strengthening the qi，and awakening the spleen to pass the qi；in the late stage，it focuses on tonifying the kidney in three ways：filling in the kidneys and fixing the essence，nourishing the kidneys to fill up the essence，warming the kidneys to raise the essence，and the spleen and kidney are regulated together. The overall emphasis on comprehensive diagnosis，the use of multiple methods，and the use of medication，flexible compounding，with good therapeutic effects，is worthy of reference and discussion.