现代中医临床2025，Vol.32Issue(2)：51-55,5.DOI:10.3969/j.issn.2095-6606.2025.02.011
从"火血同病"论治弥漫大B细胞淋巴瘤嵌合抗原受体T细胞免疫疗法后血小板减少
Treatment of post-CAR-T-induced thrombocytopenia in diffuse large B-cell lymphoma based on the concept of"fire and blood as one disease"
摘要
Abstract
Diffuse large B-cell lymphoma(DLBCL)is currently the most common non-Hodgkin lymphoma worldwide.Chimeric antigen receptor T-cell immunotherapy(CAR-T)involves the genetic modification and massive expansion of T cells,which are then re-infused into the patient.This therapy can be likened to the"fire pathogen"in Traditional Chinese Medicine(TCM),caused by external influences such as the six evils.Thrombocytopenia is one of the most common hematologic adverse reactions associated with this therapy.According to Tang Zonghai,"blood and fire are one family"and"treating fire is treating blood".In Jingyue Quanshu(The Complete Works of[Zhang]Jing-yue),the pathogenesis of bleeding is summarized as"excessive fire"and"qi injury",where"blood movement is caused by fire and qi".Externally,excessive fire agitates the blood,and internally,dysfunction in the five organs—especially the spleen—leads to stagnation of blood circulation.Therefore,in treating thrombocytopenia related to CAR-T therapy,the initial focus should be on clearing fire from the heart and liver;in the intermediate stage,tonifying the spleen and blood,and nourishing spleen yin;and in the later stage,balancing metal and water while also addressing the lung and kidney.This article discusses the treatment of thrombocytopenia after CAR-T therapy for DLBCL based on the"fire and blood as one disease"concept and presents clinical case studies.关键词
嵌合抗原受体T细胞免疫疗法/火血同病/弥漫大B细胞淋巴瘤/血小板减少Key words
CAR-T/fire and blood as one disease/DLBCL/thrombocytopenia分类
中医学引用本文复制引用
杜笑丰,张雅月,贠张君,刘铸,赵洪彬,侯丽..从"火血同病"论治弥漫大B细胞淋巴瘤嵌合抗原受体T细胞免疫疗法后血小板减少[J].现代中医临床,2025,32(2):51-55,5.基金项目
中央高水平中医医院临床科研业务费资助(No.CZ015) （No.CZ015）
中华中医药学会青年求实项目(No.2023-QNQS-05) （No.2023-QNQS-05）
国家中医药管理局高水平中医药重点学科建设项目(No.zyyzdxk-2023268) （No.zyyzdxk-2023268）
