顺铂导致化疗相关恶心呕吐反应的中药防治.pdf

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1、第3o卷第瑚长春中医药大学学报Vo1．302014年8月JournalofChangchunUniversityofTraditionalChineseMedicine8，2014DOI：10．13463／j．cnki．cczyy．2014．04．031顺铂导致化疗相关恶心呕吐反应的中药防治芦殿荣，芦殿香，殷玉琨，何生奇，于建华，柏大鹏。，王芳，高音，杜艳林，王宁军，冯利(1．中国中医科学院望京医院肿瘤科，北京100102；2．青海大学医学院高原医学研究中心，西宁810001；3．北京中医药大学，北京100029)摘要：中医认为，顺铂(化疗)导致相关恶心呕吐反应(CINV)的病因病机为药

2、物毒邪伤正致脾胃虚弱，脾不运湿，湿浊内生，胃失和降，胃气上逆所致，证属本虚标实。临床分为实证、虚证、虚实夹杂证。实证多分为痰湿中阻、肝郁气滞、脾胃湿热等型；虚证常分为脾胃虚寒、胃阴不足、脾胃气虚等型。治法多为化痰、益气、健脾、降逆、温中、逐瘀。常用方剂，以化痰为主者如小半夏汤、小半夏加茯苓汤、温胆汤、苓桂术甘汤；以益气为主者如香砂六君子汤、柴芍六君子汤、四君子汤、参苓白术散；以降逆为主者如旋覆代赭汤等。临证采用中西医结合疗法，能取长补短，提高止吐效果，减少不良反应，改善患者生活质量，提高化疗依从性。关键词：顺铂；恶心呕吐反应(CINV)；病因病机；中医药防治中图分类号：R273文献标志码

3、：A文章编号：2095—6258(2014)04—0645—03TCMtreatmentonchemotherapyinducednauseaandvomitingLUDianrong，LUDianxiang2YINYukun，HEShengqi，YUJianhua，BAIDapeng3，，WANGFang，GAOYin，DUYanlin，WANGNingjun‘，FENGLi(1．OneologyDepartmentofWangjingHospital，ChinaAcademyofChineseMedicalSciences，Beijing100102，China；2．Research

4、CenterforHighAltitudeMedicine，QinghaiUniversity，Xining810001，China；3．BeijingUniversityofChineseMedicine，Beijing100029，China)Abstract：AccordingtotraditionalChinesemedicine，thepathogenesisofchemotherapyinducednauseaandvomitingcausedbycisplatinistheweaknessinthespleenandstomachcausedbydrugtoxinasspl

5、eendonottransportanddigestwetcans-ingendogenousdampnessandstomachqiupwardreversecausingthedisorderofthestomachqi，whichissyndromeofdeft—ciencybenandexcessivebiao．Inclinic，itssyndromecouldbedividedintothreekinds：excesssyndrome，deficiencysyn—dromeandintermingleddeficiencyandexcesssyndrome．Syndromeof

6、excessisusuallydividedintoretentionofphlegmaticdampness，stagnationofliverQi，andspleenstomachdampheat，etcandsyndromeofexcessusuallyspleendeficiency，stom—achyindeficiency，anddeficiencyofspleenqiandstomachqi，etc．Therefore，thecommonlyusedtreatmentmethodsarere—ducingphlegm，tonifyingqi，strengtheningspl

7、een，calmingtheadverse-risingenergy，wanningthespleenandstomachorre—movingstasis，etc，Toreducephlegm，formulalikesmallpinelliaedecoctionisused，whichincludessmallpinelliaeporiato—getherwithfulingdecoction，Wendantangdecoctio