1.江苏省中医院,江苏省南京市秦淮区汉中路155号,210029
2.南京中医药大学
ding021304129@163.com
收稿:2025-08-27,
修回:2025-10-28,
纸质出版:2026-03-02
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祝金标,袁梦云,白璐等.从《黄帝内经》血枯病探讨肿瘤厌食-恶病质综合征的病机及辨治思路[J].中医杂志,2026,67(05):575-579.
ZHU Jinbiao, YUAN Mengyun, BAI Lu, et al. Pathogenesis and Treatment Approach of Cancer-Related Anorexia-Cachexia Syndrome Based on the Concept of "Blood Exhaustion" in
祝金标,袁梦云,白璐等.从《黄帝内经》血枯病探讨肿瘤厌食-恶病质综合征的病机及辨治思路[J].中医杂志,2026,67(05):575-579. DOI: 10.13288/j.11-2166/r.2026.05.017.
ZHU Jinbiao, YUAN Mengyun, BAI Lu, et al. Pathogenesis and Treatment Approach of Cancer-Related Anorexia-Cachexia Syndrome Based on the Concept of "Blood Exhaustion" in
以《黄帝内经》血枯病为指导,提出肿瘤厌食-恶病质综合征的三期辨治思路,即癌因性厌食期病机为癌伐脾胃、中焦滞运,治以健脾开胃、消积助运,选用《先醒斋医学广笔记》之资生丸或《医学衷中参西录》之资生汤加减治疗;营养不良恶病质前期病机为血气失养、精亏不生,治以养血和营、温阳益气,选用黄芪建中汤加减治疗;恶病质期病机为血虚精枯、瘀血阻络,治以补虚填精、通络祛瘀,选用补中益气汤合左归饮加减治疗。
Based on the concept of "blood exhaustion" from
The
Inner Canon of Yellow Emperor
(《黄帝内经》), a three-stage syndrome differentiation and treatment strategy for cancer-related anorexia-cachexia syndrome is proposeed. In the cancer-induced anorexia stage, the pathogenesis is charact
erized by cancer consuming the spleen and stomach, leading to stagnation of transportation and transformation in the middle
jiao
(焦). Treatment should focus on strengthening the spleen, promoting appetite, dispersing accumulation, and aiding digestion, with modified
Zisheng Pills
(资生丸) in
Extensive Notes on Medicine from Xian Xing Studio
(《先醒斋医学广笔记》) or
Zisheng Decoction
(资生汤) in
Records of Chinese Medicine with Reference to Western Medicine
(《医学衷中参西录》). In the pre-cachectic stage of malnutrition, the pathogenesis involves insufficient nourishment of blood and
qi
with essence depletion hindering production. Treatment should focus on nourishing blood and harmonizing
ying
(营), warming
yang
and supplementing
qi
, and modified
Huangqi Jianzhong Decoction
(黄芪建中汤) can be used. In the cachectic stage, the pathogenesis involves blood deficiency and essence exhaustion, with blood stasis obstructing the collaterals. The therapeutic approach should focus on tonifying deficiency and replenishing essence, unblocking collaterals, and removing stasis, and modified
Buzhong Yiqi Decoction
(补中益气汤) and
Zuo Gui Beverage
(左归饮) are suggested.
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