乌梅丸治疗仑伐替尼药物相关腹泻的临证探讨

Evidence and thinking of Wumei Pills for the treatment of Lenvatinib drug-related diarrhea

关键词:  乌梅丸  方证  腹泻  靶向药  伤寒论

Key words:  Wumei Pill  prescription syndrome  diarrhea  targeted drugs  Treatise on Cold Damage Diseases

摘要:

仑伐替尼是不可手术肝癌的一线靶向药,能显著延长生存期。然而,腹泻作为仑伐替尼的常见不良反应之一,降低患者生活质量,严重腹泻会选择暂时或永久停药。针对药物相关腹泻,中医临证重心在于使患者能耐受不良反应,减少腹泻发生频次,进而保障靶向药治疗,提高患者生活质量。病程一般较久,证候常表现为大便稀溏甚或水样便、四末欠温、情志不遂。基于方证相应理论,探讨《伤寒论》经典名方乌梅丸治疗腹泻,从通阳和阴、调和寒热、疏肝和脾多维度契合病机,多获奇效。

Abstract:

Lenvatinib is a first-line target drug for inoperable liver cancer and can significantly prolong survival. However,diarrhea,as one of the common adverse effects of Lenvatinib,reduces the quality of life of patients,and severe diarrhea may choose to stop the drug temporarily or permanently. For drug-related diarrhea,traditional Chinese medicine (TCM) clinical evidence focuses on enabling patients to tolerate adverse reactions,reduce the frequency of diarrhea,and then ensure targeted drug treatment and improve the quality of life of patients. The course of the disease is generally long,and the symptoms are often manifested as loose or even watery stools,hypothermia,and emotional failure. Based on the dialectical theory,the thesis discusses the treatment of diarrhea by the classic prescription of Treatise on Cold Damage Diseases,which fits the disease mechanism from the multi-dimensional mechanism of yang and yin,reconciles cold and heat,and thins the liver and strengthen the spleen,and obtains many miraculous effects.