浙江中医药大学附属第一医院/浙江省中医院 杭州 310006
Prof. ZHOU Yuhong, Chief Physician, Doctoral Supervisor. The First Affiliated Hospital of Zhejiang Chinese Medical University/Zhejiang Provincial Hosptial of Chinese Medicine, No.54, Youdian Road, Hangzhou 310006. E-mail: zyhblood@163.com
纸质出版日期:2023-10-30,
网络出版日期:2023-08-11,
收稿日期:2023-03-09,
移动端阅览
周郁鸿. 中医药治疗慢性再生障碍性贫血研究述评[J]. 北京中医药大学学报, 2023,46(10):1461-1466.
ZHOU Yuhong. Comment on the research of chronic aplastic anemia treatment with traditional Chinese medicine[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(10):1461-1466.
周郁鸿. 中医药治疗慢性再生障碍性贫血研究述评[J]. 北京中医药大学学报, 2023,46(10):1461-1466. DOI: 10.3969/j.issn.1006-2157.2023.10.019.
ZHOU Yuhong. Comment on the research of chronic aplastic anemia treatment with traditional Chinese medicine[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(10):1461-1466. DOI: 10.3969/j.issn.1006-2157.2023.10.019.
再生障碍性贫血是一种骨髓造血衰竭性疾病,以骨髓造血干细胞减少和全血细胞减少为特征。本病归属于中医学的“血证”“虚劳”“髓枯”“血虚”等范畴。近年来,再生障碍性贫血的发病率逐渐升高,但现有西医治疗手段有限,且存在长期疗效欠佳、不良反应大等局限性,而中医药在该病的治疗中具有独特的优势。中医药治疗再生障碍性贫血的研究始于20世纪50年代,至今已发展70余年。经过众多医家理论与实践的探索,逐渐形成了以补肾为核心,健脾益气、活血化瘀、泻火调肝、祛痰为辅的基本治则。本文围绕再生障碍性贫血理论溯源、中医证候类型演变、治法研究、中医药实验进展进行论述,并针对目前存在的问题提出建议和展望,以期为中医药治疗再生障碍性贫血的蓬勃发展添砖加瓦。
Aplastic anemia is a bone marrow hematopoietic failure disease
characterized as a decrease in bone marrow hematopoietic stem cells and pancytopenia. This disease belongs to the categories of "blood syndrome"
"deficiency and fatigue"
"marrow necrosis"
and "blood deficiency" in traditional Chinese medicine. In recent years
the incidence rate of aplastic anemia has gradually increased
but the existing western medicine treatment methods are limited
with poor long-term efficacy and larger adverse reactions. Conversely
traditional Chinese medicine has unique advantages in the treatment of this disease. The traditional Chinese medicine treatment of aplastic anemia began in the 1950 s and has developed for more than 70 years. Through the exploration of many physicians theory and practice
the basic treatment principles have gradually been formed
with tonifying the kidney as the core strategy
and with strengthening the spleen and replenishing qi
activating blood circulation for removing blood stasis
purging fire and regulating the liver
and dispelling phlegm as auxiliary strategies. This article summarizes the theoretical origin
evolution of syndrome types
treatment research
and experimental progress of traditional Chinese medicine in the treatment of aplastic anemia
and puts forward suggestions for the existing problems in order to contribute to the development of traditional Chinese medicine in the treatment of aplastic anemia.
慢性再生障碍性贫血中医药研究进展
chronic aplastic anemiatraditional Chinese medicineresearch progress
中华医学会血液学分会红细胞疾病(贫血)学组.再生障碍性贫血诊断与治疗中国专家共识(2017年版)[J].中华血液学杂志,2017,38(1):1-5.
中华医学会血液学分会红细胞疾病(贫血)学组. 再生障碍性贫血诊断与治疗中国指南(2022年版)[J]. 中华血液学杂志,2022, 43(11): 881-888.
陈信义,麻柔,李冬云. 规范常见血液病中医病名建议[J]. 中国中西医结合杂志,2009, 29(11): 1040-1041.
李元善,张韬玉.全国首届中西医结合血液病学术会议概况[J]. 中西医结合杂志,1983(1):61-63.
周霭祥,王展翔. 近30年中西医结合治疗及研究血液病概况与进展[C]//中国中西医结合学会.中国中西医结合学会成立20周年纪念大会论文集. 西安:2001:120-121.
中华中医药学会血液病分会. 中医治疗血液病名家学术观点撷菁[J]. 北京中医药,2021, 40(5): 466-469.
中华中医药学会. 中医内科常见病诊疗指南:西医疾病部分[M]. 北京:中国中医药出版社,2008:209-211.
吴迪炯,叶宝东,季聪华,等. 再生障碍性贫血临床实践指南研究现状及中医指南的修订与思考[J]. 中医杂志,2014, 55(4): 274-278.
国家中医药管理局医政司. 22个专业95个病种中医诊疗方案[M]. 北京:中国中医药出版社,2011:328-330.
国家中医药管理局医政司. 22个专业92个病种中医诊疗方案(合订本) [M]. 北京:中国中医药出版社,2017:384-388.
潘其伟,沈一平. 沈一平治疗慢性再生障碍性贫血经验[J]. 浙江中西医结合杂志,2017, 27(1): 1-3.
吴迪炯,周郁鸿. 周郁鸿治疗慢性再生障碍性贫血经验[J]. 中医杂志,2013, 54(4): 338-340.
全日城,郭小青,吕妍,等. 周霭祥治疗血液病思想探析[J]. 中华中医药杂志,2022, 37(8): 4507-4509.
郑仁智,高雁婷,李晓蕾,等. 基于数据挖掘研究周郁鸿治疗再生障碍性贫血用药规律 [J]. 浙江中西医结合杂志,2020, 30(3): 253-255.
张琳琳,曹宇峰,吕丽丽,等. 健脾补肾方治疗再生障碍性贫血疗效观察[J]. 河北医药,2019, 41(23): 3620-3622.
张平. 益血生胶囊联合兔抗人胸腺细胞免疫球蛋白治疗再生障碍性贫血的临床研究[J]. 现代药物与临床,2018, 33(7): 1751-1175.
徐颖,田雪姣. 生血丸联合司坦唑醇片、环孢素软胶囊对慢性再生障碍性贫血的疗效[J]. 河南医学研究,2020, 29(30): 5657-5659.
莫国增,沈一平,叶宝东. 从“瘀”论治慢性再障初探[J]. 中国现代医生,2019, 57(7): 137-140.
党辉,关徐涛,王冰. 高萍教授治疗慢性再生障碍性贫血经验[J].中华中医药学刊,2016,34(12):2845-2848.
肖鹏,袁健芳,江劲波. 从“虚,瘀,郁”论治慢性再生障碍性贫血[J]. 山西中医,2022, 38(2): 1-3.
钱玉红. 探讨健脾补肾活血汤治疗慢性再生障碍性贫血的临床效果[J]. 中医临床研究,2016, 8(19): 102-103.
王珊,陈建玲,孙继生,等. 健脾补肾活血法联合小剂量雄激素治疗慢性再生障碍性贫血临床观察[J]. 光明中医,2019, 34(24): 3807-3809.
孙伟玲,胡明辉,周永明. 健脾补肾活血法联合小剂量安雄治疗慢性再障的疗效及生存质量观察[J].华夏医学,2016,29(3):36-41..
刘文宾,吴迪炯,叶宝东,等. 慢性再生障碍性贫血患者铁过载与中医血瘀证的相关性研究[J]. 中国中西医结合杂志,2018, 38(1): 38-41.
刘文宾,沈晓玲,俞颖,等. 补肾活血方治疗慢性再生障碍性贫血合并铁过载的临床疗效观察[J]. 中华中医药杂志,2022, 37(3): 1822-1825.
仇如意,叶宝东,侯佳慧,等. “补肾活血”法治疗慢性再生障碍性贫血患者输血相关性铁负荷过载的效果分析[J]. 中国输血杂志,2021, 34(7): 720-724.
吴迪炯,罗贇飞,刘文宾,等. 慢性“髓劳”患者“血瘀证”与铁负荷过载的相关性研究[J]. 浙江中医药大学学报,2016, 40(4): 265-269.
周怡驰,汤朝晖,秦灵鸽,等. 张新渝补肾解毒泻肝法治疗慢性再生障碍性贫血经验举要[J]. 江苏中医药,2018, 50(4): 24-26.
周韶虹,甘晓芳,许毅. 黄振翘从“泻肝清火,寓泻于补”论治再生障碍性贫血[J]. 上海中医药杂志,2007, 41(6): 10-11.
吴晓勇. 傅汝林治疗慢性再生障碍性贫血经验介绍[J].北京中医药,2008,27(6):429-430.
刘宝山,戴锡孟,再生障碍性贫血痰瘀互结病机理论基础及应用探微[J].中国中医基础医学杂志,2006,12(9):688-689.
王雪,张慧,吴敏,等. 张慧从“湿”从“瘀”论治慢性再生障碍性贫血经验浅析[J]. 辽宁中医杂志,2014, 41(4): 645-647.
吴迪炯,王其莉,沈慧芬,等. “痰瘀同治”法对再生障碍性贫血小鼠骨髓有核细胞凋亡的影响及其机制[J]. 中华中医药学刊,2010, 28(10): 2080-2084.
沈慧芬,周郁鸿,沈一平. 周郁鸿教授自拟祛痰补肾汤治疗慢性再生障碍性贫血经验[J]. 浙江中医药大学学报,2012, 36(12): 1264-1265.
李芮,丁宇斌,王文儒,等. 补肾生血方治疗慢性再生障碍性贫血的临床疗效及对T细胞亚群,T-bet与GATA3表达的影响[J]. 中国实验方剂学杂志,2022, 28(15): 94-101.
YANG X, HUANG CG, DU SY, et al. Effect of Danggui Buxue Tang on immune-mediated aplastic anemia bone marrow proliferation mice [J]. Phytomedicine, 2014, 21(5): 640-646.
ZHOU JW, LI X, DENG PY, et al. Chinese Herbal Formula, Modified Danggui Buxue Tang, Attenuates Apoptosis of Hematopoietic Stem Cells in Immune-Mediated Aplastic Anemia Mouse Model [J/OL]. J Immunol Res, 2017, 2017: 9786972[2023-02-16]. https://www.hindawi.com/journals/jir/2017/9786972/https://www.hindawi.com/journals/jir/2017/9786972/.
ZHANG L, NI RF, LI JN, et al. Dioscin Regulating Bone Marrow Apoptosis in Aplastic Anemia [J]. Drug Des Devel Ther, 2022, 16: 3041-3053.
王琰,崔思远,丁淑敏,等. 补肾益髓生血颗粒治疗慢性再生障碍性贫血疗效及调控端粒机制研究[J]. 中药药理与临床,2021, 37(2): 172-177.
EDOUARD MJ, MIAO L, FAN GW, et al. Yang-tonifying traditional Chinese medicinal plants and their potential phytoandrogenic activity [J]. Chin J Nat Med, 2014, 12(5): 321-324.
丁奇. 补髓生血颗粒对慢性再生障碍性贫血负性造血调控因子的影响[J]. 中国中医药现代远程教育,2019, 17(18): 59-61.
祝佳嘉,周郁鸿. 补肾益气法与单纯补肾法治疗慢性再生障碍性贫血的临床疗效比较 [J]. 浙江中医药大学学报,2012, 36(1): 17-20.
LI HC, JI LN, SHEN YY, et al. Bushen Jianpi Quyu Formula Alleviates Myelosuppression of an Immune-Mediated Aplastic Anemia Mouse Model via Inhibiting Expression of the PI3K/AKT/NF-kappaB Signaling Pathway [J/OL]. Evid Based Complement Alternat Med, 2022, 2022: 9033297[2023-02-16]. https://www.hindawi.com/journals/ecam/2022/9033297/https://www.hindawi.com/journals/ecam/2022/9033297/.
YE BD, CHEN D, WU DJ, et al. Effect of kidney-reinforcing, blood-activating and stasis-removing recipes on adhesion molecule expression of bone marrow mesenchymal stem cells from chronic aplastic anemia patients [J]. J Tradit Chin Med, 2012, 32(4): 596-603.
王金环,谷梦宇,于孙婉琪,等. 补肾生血法治疗慢性再障的临床观察及对ICAM-1表达的影响研究[J]. 中医药学报,2022, 50(4): 41-45.
0
浏览量
146
下载量
1
CSCD
关联资源
相关文章
相关作者
相关机构