| 方逸雯,邵诗思,叶宝东,等.肠道移植物抗宿主病中医辨识与实践[J].浙江中医药大学学报,2024,48(9):1110-1115. |
| 肠道移植物抗宿主病中医辨识与实践 |
| Recognition and Practice of Traditional Chinese Medicine in Intestinal Graft-Versus-Host Disease |
| DOI：10.16466/j.issn1005-5509.2024.09.007 |
| 中文关键词: 移植物抗宿主病 异基因造血干细胞移植 肠病 扶正化邪 名医经验 中医药疗法 钦丹萍 |
| 英文关键词: graft-versus-host disease allogeneic hematopoietic stem cell transplantation enteropathy strengthening the body resistance and resolving pathogen experience of famous doctors Chinese medicine therapy QIN Danping |
| 基金项目:浙江省钦丹萍名老中医专家传承工作室项目(GZS2020020) |
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| 中文摘要: |
| [目的] 总结钦丹萍教授运用中医药治疗肠道移植物抗宿主病的经验。[方法] 通过跟师临证，收集、整理医案，从疾病认识、证候变迁、临证化裁方面总结钦丹萍教授临床治疗肠道移植物抗宿主病的学术特色，并附医案加以佐证。[结果] 钦丹萍教授认为，接受移植的患者机体为本体，移植的异基因造血干细胞为客体，肠道移植物抗宿主病以脾虚为本，移植后客体入里化生湿、热、寒、瘀、毒而为标，正邪相争，作用于肠道而为病，病机为本虚标实。治疗方面强调标本兼治，针对本虚，以健脾益气为基本原则；针对标实，重在化解湿热寒瘀毒，以使正邪相容而疾病得安。所举医案分别为胃肠急性移植物抗宿主病和肠道慢性移植物抗宿主病，分别治以健脾清化、和中止泻与平调寒热、健脾止泻，收效甚佳。[结论] 钦丹萍教授以本体客体相容为目标，以“扶正化邪”为核心治疗肠道移植物抗宿主病，在改善患者临床症状及缓解肠道黏膜炎症方面疗效显著，值得进一步探索学习。 |
| 英文摘要: |
| [Objective] To summarize Professor QIN Danping’s experience in applying traditional Chinese medicine to treat intestinal graft-versus-host disease. [Methods] Through following Professor QIN’s outpatient service， collecting and sorting out medical cases， the academic characteristics of Professor QIN in treatment of intestinal graft-versus-host disease were summarized from the aspects of disease cognition， syndrome evolution and clinical treatment， and the medical cases were attached to support it. [Results] It is believed that the patient of transplant is the subject， the transplanted allogeneic hematopoietic stem cells are the objects and spleen deficiency is the basis. After transplantation， the object enter the body to produce dampness，heat，cold， stasis and toxin， which act on the intestine to cause disease. The pathogenesis of the disease is root deficiency and branch excess. Treatment emphasizes both symptoms and root causes， invigorating the spleen and supplementing Qi is basic treatment principle， dispelling dampness， regulating cold and heat， regulating Qi and dissolving stasis are manifestations， to make the vital Qi and evil Qi mutually inclusive and the disease achieve stable. The medical cases mentioned were acute gastrointestinal graft-versus-host disease and chronic intestinal graft-versus-host disease， were treated by strengthening the spleen and clearing dampness-heat， harmonizing stomach and stopping diarrhea， regulating cold and heat， strengthening the spleen to control diarrhea separately， and both cases achieved significant effect. [Conclusion] Professor QIN aims at making the ontology and foreign body mutually inclusive， adopts “strengthening the body resistance and resolving pathogen”as the core in the treatment of intestinal graft-versus-host disease， improves clinical symptoms and alleviates the intestinal mucosal inflammation， which is worth further exploration. |
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