摘要
化疗后中性粒细胞减少症(chemotherapy-induced neutropenia,CIN)是化疗患者常见的不良反应,与临床患者感染甚至死亡风险直接相关。研究表明,“卫气”的防御作用与中性粒细胞免疫功能密切相关,中性粒细胞胞外诱捕网(Neutrophil extracellular traps,NETs)异常堆积是化疗后中性粒细胞减少症发生的关键病理环节,与中医“卫气稽留”病机表征关联。基于中医理论和临床实践,结合现代医学及分子生物学研究成果,认识到肺、脾、肾三脏亏虚是“卫气稽留”病因病机之根,因卫气虚损,失其慓疾,推动无力,卫气行迟,以及卫虚营损,血少脉道不充,脉道艰涩,营血壅滞,均致卫气稽留,诱发或加重CIN。据此提出“肺脾肾亏虚-卫气稽留-NETs异常堆积-CIN关联”病因病机新假说,丰富中医CIN病因病机的科学内涵,为益气行卫、养血通营方药干预CIN提供新策略、开辟新思路。
Chemotherapy-induced neutropenia(CIN)is a common adverse reaction in chemotherapy patients,which is directly related to the risk of infection and even death in clinical patients.Studies have shown that the defensive effect of"wei qi"is closely related to the immune function of neutrophils,and the abnormal accumulation of neutrophil extracellular traps(NETs)is the key mechanism of CIN,which is consistent with the pathogenesis of"wei qi retention".Based on TCM theory and clinical practice,combined with modern medicine and molecular biology research,the author has recognized that the deficiency of lung,spleen and kidney is the fundamental cause of"wei qi retention".Due to the deficiency of wei qi,the flow of wei qi becomes sluggish,and deficiency of wei qi,damage of camp blood,insufficiency of blood vessel,resulting in blood stasis,leading to"retention of wei qi",induce or aggravate CIN.Accordingly,a new hypothesis of"deficiency of lung,spleen and kidney-wei qi retention-abnormal accumulation of NETs-CIN association"was proposed to enrich the scientific connotation of the etiology and pathogenesis of CIN in Traditional Chinese medicine,and to provide new strategies and ideas for the intervention of CIN with the treatment of"replenishing qi,running wei qi,nourishing blood and promoting the circulation".
作者
高颖
叶欣
向句一
夏婷
曾进浩
Gao Ying;Ye Xin;Xiang Juyi;Xia Ting;Zeng Jinhao(Affiliated Hospital of Chengdu University of Traditional Chinese Medicine,Chengdu 610075,China)
出处
《世界科学技术-中医药现代化》
CSCD
北大核心
2022年第9期3638-3643,共6页
Modernization of Traditional Chinese Medicine and Materia Medica-World Science and Technology
基金
四川省中医药管理局中医药重点学科建设项目(2100601):中医肿瘤病学,负责人:由凤鸣
成都中医药大学附属医院科研能力提升“百人计划”项目(21-Y17):肿瘤的中医药防治优势及特色研究,负责人:曾进浩
关键词
卫气稽留
化疗后中性粒细胞减少症
病机
中性粒细胞胞外诱捕网
益气行卫
养血通营
Retention of wei qi
Chemotherapy-induced neutropenia
Pathogenesis
Neutrophil extracellular traps
Replenishing qi and running wei qi
Nourishing blood and promoting the circulation
作者简介
通讯作者:曾进浩,博士,副教授,主要研究方向:中医药防治肿瘤的临床及基础研究。
