传统古方在化疗相关性腹泻中的应用.docVIP

传统古方在化疗相关性腹泻中的应用 　　[摘要] 化疗相关性腹泻已成为肿瘤化疗患者常见的不良反应。随着中医药研究的发展，使用中医传统古方治疗化疗相关性腹泻在临床取得了较好的效果，具有西医不能替代的独特优势。笔者对近年来临床使用较多的传统古方进行了整理和分析，着重从中医辨证论治的角度探讨传统古方在化疗相关性腹泻中的应用，为取得更满意的疗效和实验研究提供理论依据。 　　[关键词] 传统古方；化疗相关性腹泻；辩证论治 　　[中图分类号] R256.34 [文献标识码] A [文章编号] 1673-7210（2013）11（c）-0025-04 　　Application of traditional Chinese medicine prescription in chemotherapy-induced diarrhea 　　LI Yufeng CHEN Zijun 　　Prescription Teaching and Research Section， Pharmacology College of Shanghai University of Traditional Chinese Medicine， Shanghai 201203， China 　　[Abstract] Chemotherapy-induced diarrhea has become a common adverse reaction of cancer chemotherapy patients. With the development of the traditional Chinese medicine research， using traditional Chinese medicine prescription in treatment of chemotherapy-induced diarrhea has achieved a good clinical efficacy and has the unique advantages， which can not be replaced by western medicine. The author collected and analyzed the frequently used traditional Chinese medicine prescription in recent years， focusing on the angle of treatment based on syndrome differentiation discussed the application of traditional Chinese medicine prescription， to provide theoretical foundations for achieving more satisfactory curative effect and experimental research. 　　[Key words] Traditional Chinese medicine prescription ； Chemotherapy-induced diarrhea； Treatment based on syndrome differentiation 　　腹泻是肿瘤患者化疗最常见的不良反应之一[1-3]，称为化疗相关性腹泻（chemotherapy-induced diarrhea，CID）。近年来随着大批化疗新药的面世及应用，CID以伊立替康（irinotecan，CPT-11）和氟尿嘧啶（fluorouracil）引起的腹泻发生率最高，可达80%[4]。化疗诱发的腹泻不仅会使水和电解质的平衡失调，血容量减少，增加感染的发生率，而且还会降低患者的体质和生活质量，甚至危及生命，导致化疗被迫中断[5]。国际上对于CID尚无满意的治疗方案[6]，大多是以止泻为主的被动对症治疗，没从根本上调理肠胃功能，成为临床治疗的难点，给患者带来极大的经济负担[7]。 　　随着中医药的发展，传统古方治疗化疗相关性腹泻取得较好的疗效，展示出中医药在防治化疗药物毒副反应方面的独特优势。中医认为化疗相关性腹泻属“泄泻”、“下利”等病证范畴。正如《景岳全书·泄泻》云：“泄泻之本，无不由于脾胃”。认为化疗药物耗伤人体正气，脾失健运，胃失和降，水谷不化，内生湿热，而导致大肠传导功能失常而发病[8]。中医采用辨证论治的方法，扶正祛邪，标本兼顾。在治法上，多用平调寒热、益气健脾、温阳健脾、健脾渗湿、调和肝脾等方法。笔者特对此类古方加以整理，从古方的出处、方药组成、功用主治、辨证要点等方面做以下综述：