中医杂志

基于《难经》“脾主裹血”，提出药毒伐中、脾虚失裹是肿瘤治疗相关血小板减少症的核心病机。认为抗肿瘤药毒直折中州，致使脾气亏虚，化源枯竭，生血乏源；脉络失养，形质受损，血失裹藏，遂泛溢脉外；药毒久羁，易致离经成瘀，日久暗耗真精。针对此本虚标实之候，提出治疗当以健脾益气摄血为核心，重塑脾胃运化功能，修复脉络受损形质，以复裹藏之功；并随证配伍宁络固脉、祛瘀生新、填精益髓之品，以期为中医药防治肿瘤治疗相关血小板减少症提供思路。

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.