| 摘要: |
| 介绍国医大师潘敏求教授（以下尊称“潘老”）基于“脾- 肾气化协同轴”诊治抗肿瘤药物所致骨
髓抑制的临证经验。潘老认为抗肿瘤药物所致骨髓抑制的发生与脾肾功能失调密切相关，其根本原因在于药
物毒性破坏了“脾- 肾气化协同轴”。脾脏受损导致气血生化不足，肾脏受损无法正常藏精化髓，使邪毒滞留
于骨髓，进一步阻碍了气血的生成与运行。潘老临证注重分期辨证分型，主张采用健脾益肾法治疗本病，并以
四君子汤合当归补血汤、复方补髓汤加减为主，补气健脾以资气血生化之源，补肾填精以固根本，善用黄芪、党
参健脾益气，熟地黄、枸杞子益肾填精；又强调动态调治，结合化疗阶段、血象变化调整药量，兼顾改善骨髓造
血功能与减轻化疗毒副作用，实现“治病求本”与“对症施治”的统一。附1 则典型案例加以佐证。 |
| 关键词: 骨髓抑制 抗肿瘤药物 健脾益肾 脾肾同治 大师经验 潘敏求 |
| DOI： |
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| Experience of National Chinese Medicine Master Pan Minqiu in diagnosis and treatment of myelosuppressioninduced by antitumor drugs based on the “spleen-kidney Qi transformation synergistic axis” |
| ZENG Ling,PAN Bo,LI Linpei |
| (1. Hunan University of Chinese Medicine, Changsha 410208, Hunan, China; 2. Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine, Changsha 410006, Hunan, China) |
| Abstract: |
| This article introduces the clinical experience of National Chinese Medicine Master Professor Pan Minqiu
（hereinafter respectfully referred to as “Master Pan”） in the diagnosis and treatment of myelosuppression induced by antitumor drugs based on the “spleen-kidney Qi transformation synergistic axis”. Master Pan believes that the onset
of myelosuppression induced by antitumor drugs is closely associated with dysfunction of the spleen and kidney, with the
root cause of the destruction of the “spleen-kidney Qi transformation synergistic axis” by drug toxicity. Damage to the
spleen leads to insufficient generation of Qi and blood, while damage to the kidney impairs its normal function of storing
essence and transforming marrow, resulting in the retention of pathogenic toxins in bone marrow, which further obstructs the
generation and circulation of Qi and blood. In clinical practice, Master Pan emphasizes syndrome differentiation and staging
and proposes the method of strengthening the spleen and tonifying the kidney to treat this disease. He mainly uses the
modified prescriptions of Sijunzi decoction combined with Danggui Buxue decoction and Fufang Busui decoction, thereby
supplementing Qi and strengthening the spleen to support the source of the generation of Qi and blood and nourishing kidney-
essence to consolidate the root. He skillfully uses Astragalus membranaceus and Codonopsis pilosula to strengthen the
spleen and benefit Qi and applies prepared Radix Rehmanniae and Lycium barbarum L. to tonify the kidney and nourish
essence. Furthermore, he emphasizes the importance of dynamic regulation, adjusting doses based on chemotherapy stages
and changes in hemogram parameters and achieving the balance between improving the hematopoietic function of bone
marrow and reducing the toxicity and side effects of chemotherapy, thereby realizing the unity of “treatment aiming at its
root causes” and “symptomatic treatment”. A typical case is attached as evidence. |
| Key words: myelosuppression antitumor drugs strengthening the spleen and tonifying the kidney simultaneous
treatment of spleen and kidney master experience Pan Minqiu |
