1.成都中医药大学附属医院,四川省成都市金牛区十二桥路39号,610072
2.重庆市中医院
3.成都中医药大学肿瘤学教研室
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收稿:2024-12-18,
修回:2025-02-16,
纸质出版:2025-06-02
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龙静,赖恒周,黄文博等.化疗相关骨髓抑制的虚气留滞病机演变与分度论治[J].中医杂志,2025,66(11):1109-1113.
LONG Jing,LAI Hengzhou,HUANG Wenbo,et al.Pathophysiological Evolution and Syndrome-Based Stratified Treatment of Qi Deficiency with Stagnation in Chemotherapy-Induced Myelosuppression[J].Journal of Traditional Chinese Medicine,2025,66(11):1109-1113.
龙静,赖恒周,黄文博等.化疗相关骨髓抑制的虚气留滞病机演变与分度论治[J].中医杂志,2025,66(11):1109-1113. DOI: 10.13288/j.11-2166/r.2025.11.005.
LONG Jing,LAI Hengzhou,HUANG Wenbo,et al.Pathophysiological Evolution and Syndrome-Based Stratified Treatment of Qi Deficiency with Stagnation in Chemotherapy-Induced Myelosuppression[J].Journal of Traditional Chinese Medicine,2025,66(11):1109-1113. DOI: 10.13288/j.11-2166/r.2025.11.005.
“虚气留滞”原指元气亏损,气化障碍,发生积滞的病理表现。在肿瘤周期性化疗模式下,骨髓抑制历经因虚渐滞,虚滞相继加重的病理进程。认为骨髓抑制从轻度向重度的时序性病机演变契合“虚气留滞”动态辨治体系,“虚气”即气血、精髓渐进亏耗,“留滞”即痰浊、瘀血相继盘踞,“虚气”与“留滞”互为因果,形成因虚留滞、滞更伤正的恶性循环。轻度骨髓抑制阶段,化疗药毒初入,蕴结骨髓,以气耗血虚阴损,痰湿浊邪留滞为渐。重度骨髓抑制阶段,药毒蓄积,以气虚陷下,精亏髓耗,瘀踞络阻为著。治疗当辨其轻重而治之,审其虚实而调之,以奏标本同治之功。
The concept of "
qi
deficiency with stagnation" refers to a pathological state characterized by the depletion of primordial
qi
, impaired
qi
transformation, and the development of internal stagnation. Under the cyclic chemotherapy regimen in oncology, chemotherapy-induced myelosuppression follows a progressive pathological course from
qi
deficiency to increasing stagnation. This sequential evolution from mild to severe myelosuppression closely aligns with the dynamic syndrome differentiation and treatment framework of "
qi
deficiency with stagnation"
.
"
Qi
deficiency" reflects the gradual depletion of
qi
, blood, and essence, while "stagnation" refers to the accumulation of phlegm, turbid dampness, and blood stasis. These two components interact reciprocally, forming a vicious cycle where deficiency leads to stagnation, and stagnation further damages the healthy
qi
. In the early stage of mild myelosuppression, chemotoxicity begins to accumulate in the bone marrow, leading to
qi
consumption, blood deficiency,
yin
injury, and the gradual formation of turbid phlegm and damp stagnation. In the advanced stage of severe myelosuppression, the accumulation of toxicity causes
qi
sinking, exhaustion of essence, and marrow depletion, along with blood stasis obstructing the collaterals. Treatment strategies should be based on syndrome differentiation, with an emphasis on assessing the severity of the condition, balancing deficiency and excess, and achieving both symptomatic relief and root cause resolution.
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