1.中国中医科学院广安门医院,北京市西城区北线阁5号,100053
2.北京中医药大学研究生院
houwei1964@163. com
收稿:2022-10-14,
修回:2023-02-08,
纸质出版:2023-05-02
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胡帅航,王丹丹,马秀梅等.基于《金匮要略》“干血”治则分阶段论治放射性皮肤损伤[J].中医杂志,2023,64(09):896-900.
HU Shuaihang,WANG Dandan,MA Xiumei,et al.Construction of Core Outcome Set for Diabetic Foot in Traditional Chinese Medicine Clinical Researches[J].Journal of Traditional Chinese Medicine,2023,64(09):896-900.
胡帅航,王丹丹,马秀梅等.基于《金匮要略》“干血”治则分阶段论治放射性皮肤损伤[J].中医杂志,2023,64(09):896-900. DOI: 10.13288/j.11-2166/r.2023.09.007.
HU Shuaihang,WANG Dandan,MA Xiumei,et al.Construction of Core Outcome Set for Diabetic Foot in Traditional Chinese Medicine Clinical Researches[J].Journal of Traditional Chinese Medicine,2023,64(09):896-900. DOI: 10.13288/j.11-2166/r.2023.09.007.
放射性皮肤损伤常发生于放疗之后,放射产生的毒邪淤积化热,煎灼津血,血热致瘀,加之肿瘤患者多属痰瘀毒结体质,日久则变为胶结难化之“干血”(《金匮要略》)。认为在放射性皮肤损伤的整个疾病变化过程中均伴有瘀血生成,瘀血日久易化为“干血”,“干血”不去则“新血”难生,局部失去血液濡养功能,进而导致不同程度的皮肤损伤。据此针对本病不同阶段提出“三期三法”进行论治,即放疗前期“治未病”,滋阴润燥,减轻热毒侵蚀;放疗中期“祛邪气”,泻火解毒,防止病邪深入;放疗后期“清余邪”,补虚润燥,以防邪气久稽。将“活血”之法贯穿全程,以促“新血”润“新肤”,可为临床诊治提供思路。
Radiation skin injury often occurs after radiotherapy. The toxins produced by the radiation accumulate and transform into heat, scorching the fluids and blood, and blood heat causes stasis. In addition, most tumor patients are of phlegm, blood stasis and toxin knot constitution, and these will become “dried blood” that is hard to dissolve. It is believed that blood stasis is formed throughout the whole process of radiation skin injury, and the blood stasis will easily transform into “dried blood” over time. If the “dried blood” cannot be dispelled, the generation of “new blood” will be hard, thereby leading to the dysfunction of blood nourishment in local parts, and further producing skin injuries to varied degrees. Therefore, we propose “three stages and three methods” to treat radiation skin injury by different stages. In the early stage of radiotherapy, following the principle of “treat disease before it arises”, the method of enriching
yin
and moistening dryness is used to reduce heat and toxin erosion. In the middle stage, it is important to dispel pathogenic
qi
with the method of draining fire and resolving toxins, so that the pathogens will not invade further. In the late stage, it is suggested to clear residual pathogen, supplement deficiency and moisten dryness, preventing long-term accumulation of pathogenic
qi
. The method of “activating blood” runs through the whole process o promote “new blood” and moisten “new skin”, which can provide new ideas for clinical diagnosis and treatment.
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