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1.河南中医药大学儿科医学院 郑州 450046
2.河南中医药大学第一附属医院
Prof.DING Ying, Master of Chinese Medicine, Chief Physician, Doctoral Supervisor.School of Pediatrics, Henan University of Chinese Medicine, No.1, Jinshui Road, Jinshui District, Zhengzhou 450046.E-mail: dingying3236@ sina.com
Received:17 October 2022,
Published Online:03 March 2023,
Published:30 April 2023
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HAN Shanshan, DAI Yanlin, DING Ying, et al. Discussion on the treatment of toxic side effects of immunosuppressants from the perspective of "treating deficiency with three sources and two systems"[J]. Journal of beijing university of traditional chinese medicine, 2023, 46(4): 450-455.
HAN Shanshan, DAI Yanlin, DING Ying, et al. Discussion on the treatment of toxic side effects of immunosuppressants from the perspective of "treating deficiency with three sources and two systems"[J]. Journal of beijing university of traditional chinese medicine, 2023, 46(4): 450-455. DOI: 10.3969/j.issn.1006-2157.2023.04.002.
免疫抑制剂广泛应用于风湿免疫疾病的治疗,但大多数免疫抑制剂具有毒副作用,会对免疫、消化、生殖等系统造成一定的损伤,不仅降低患者的依从性,还会严重影响疾病的预后。目前,针对免疫抑制剂的毒副作用,西医学尚未给出明确的解决方案。中医学理论认为,免疫抑制剂多为糖皮质激素、细胞毒性药物等峻猛攻伐之品,久用可犯肺卫、累脾胃、伤肾元,损伤机体正气,则出现虚损症状。“治虚三本二统”是明末医家汪绮石治疗虚劳之法,经过后世不断丰富发展,已上升为治疗虚损性疾病的经典理论。本文从“治虚三本二统”的角度出发,对如何佐制免疫抑制剂的毒副作用进行梳理和研究。认为针对免疫抑制剂引起的虚损症状,当从肺、脾、肾“三本”论治,对肾阴虚证与肾阳虚证应统于肺、脾“二统”进行治疗。临床实践中可根据不同系统损伤的具体症状,确定相应治则,以期为临床安全用药提供中医的可行性方案,也为拓展中医减毒理论体系进行探索。
Immunosuppressants are widely used in the treatment of rheumatic immune diseases
but most of them have toxic side effects
causing damage to the immune
digestive
reproductive and other systems
not only reducing patient compliance
but also seriously affecting disease prognosis. At present
Western medicine has no clear solution for the toxic side effects of immunosuppressants. The theory of traditional Chinese medicine(TCM) states that immunosuppressants such as glucocorticoids and cytotoxic drugs are mainly aggressive products. Long-term use of immunosuppressants can damage the lung
spleen and kidney
damage the vital qi of the body
and lead to deficiency symptoms occur. "Treating deficiency with three sources and two systems" is the great method developed by Wang Qishi
a doctor in the late Ming Dynasty
to treat deficiency and fatigue. After continuous enrichment and development in later generations
this has become a classic theory for treating consumption diseases. We studied the toxic side effects of immunosuppressants from the perspective of "treating deficiency with three sources and two systems". We believe that the symptom of consumption caused by immunosuppressants should be treated from the "three sources" of lung
spleen and kidney
and the two types of syndromes of kidney yin deficiency and kidney yang deficiency should be treated from the "two systems" of lung and spleen. In clinical practice
we can determine the corresponding treatment principles according to different system’s injury syndromes
so as to provide a TCM scheme for safe clinical drug use and expand the theoretical system of toxicity reduction based on TCM.
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