中医杂志2026，Vol.67Issue(17)：1835-1839,5.DOI:10.13288/j.11-2166/r.2026.17.006
基于"脾主裹血"探讨肿瘤治疗相关血小板减少症的病机及辨治思路
Pathogenesis and Treatment of Cancer Therapy Induced Thrombocytopenia based on the Theory of'Spleen Governing the Containment of Blood'
摘要
Abstract
Based on the theory of'spleen governing the containment of blood'in The Classic of Difficult Issues(《难经》),it is proposed that medication toxicity damaging the middle jiao(焦)and failure of the spleen to contain blood constitute the core pathogenesis of cancer therapy induced thrombocytopenia(CTIT).It is believed that the anti-tumor drug toxicity directly hits middle jiao,leading to spleen qi depletion,impairment of transportation and transformation,and insufficiency of the source of blood production.Consequently,the vessels and collaterals are deprived of nourishment and become structurally damaged.Blood fails to be contained and stored within the vessels,resulting in extravasation beyond the vascular system.Persistent retention of drug toxicity may further cause stasis due to blood deviating from its normal pathway and gradually consume the essence.In view of this root deficiency with branch excess,it is proposed that the treatment should focus on fortifying spleen,boosting qi and containing blood,with the aim of restoring spleen and stomach transportation functions,repairing vascular damage,and recovering the spleen's blood-containing function.According to individual syndrome patterns,prescriptions may be supplemented with herbs that stabilize vessels and consolidate collaterals,remove stasis and promote regeneration,and replenish essence and nourish marrow,providing new perspectives for the prevention and treatment of CTIT with traditional Chinese medicine.关键词
肿瘤治疗相关血小板减少症/脾主裹血/健脾益气Key words
cancer therapy induced thrombocytopenia/spleen governs the containment of blood/fortifying spleen and boosting qi引用本文复制引用
邢富威,姬凯欣,米玛贡拉,王冬雨,李佳锟,齐宇镈,张雅月..基于"脾主裹血"探讨肿瘤治疗相关血小板减少症的病机及辨治思路[J].中医杂志,2026,67(17):1835-1839,5.基金项目
国家重点研发计划青年科学家项目(2025YFC3511500) （2025YFC3511500）
中华中医药学会求实项目(2023-QNQQS-05) （2023-QNQQS-05）
国家中医药管理局高水平中医药重点学科建设项目(zyyzdxk-2023268) （zyyzdxk-2023268）
