通讯作者: 付烊, 477944861@qq.com

DOI：10.12201/bmr.202512.00010

Exploration of Classical Formula-Based Pattern Differentiation and Treatment for Chemotherapy-Induced Diarrhea Based on the Theory of Cold-Heat Complex

• 摘要：化疗相关腹泻是肿瘤治疗中的常见并发症,现代医学处理手段有限,存在疗效不稳定、易复发及副作用多等问题。中医学认为其核心病机在于化疗药毒损伤机体,导致阴阳失调、寒热错杂。本文基于“寒热错杂”理论,系统阐述化疗相关腹泻的病因病机,指出其病性属寒热并存、虚实夹杂,病位以中焦脾胃为核心,可累及上下二焦及厥阴肝经。治疗上需精准辨证,选用具有双向调节作用的经方。本文构建以泻心汤类方为“核心方”、乌梅丸为“纵深方”、黄连汤为“枢纽方”的辨治矩阵,以应对不同病位与病势的复杂证候,并总结出“首辨病位、次调寒热、终护胃气”的辨治思路,旨在为临床提供精准有效的治疗方法。

  关键词： 化疗相关腹泻; 寒热错杂; 经方; 半夏泻心汤; 乌梅丸

   

  Abstract: Chemotherapy-induced diarrhea is a common complication in cancer treatment. Modern medicine offers limited management options, which are often associated with unstable efficacy, high recurrence rates, and various side effects. Traditional Chinese Medicine posits that its core pathogenesis lies in the damage caused by chemotherapeutic toxins, which impairs the body and leads to yin-yang disharmony and a cold-heat complex. Based on the cold-heat complex theory, this paper systematically elaborates on the etiology and pathogenesis of CID, indicating that its nature involves the coexistence of cold and heat and a mixture of deficiency and excess. The primary disease location is the Middle Jiao (centered on the spleen and stomach), which may also involve the Upper and Lower Jiao, as well as the Jueyin Liver Meridian. Treatment requires precise pattern differentiation and the application of classical formulas with dual-regulating effects. This paper constructs a treatment matrix using Xiexin-Class Formulas as the Core Formula, Wumei Pill as the Depth Formula, and Huanglian Decoction as the Pivotal Formula to address complex manifestations with varying disease locations and progression. Additionally, it summarizes a diagnostic and therapeutic approach articulated as: First, identify the disease location; second, regulate cold and heat; finally, protect stomach qi, aiming to provide precise and effective clinical treatment strategies.

  Key words: Chemotherapy-induced diarrhea; cold-heat complex; classical formulas; Banxia Xiexin Decoction; Wumei Pill

  提交时间：2025-12-02

  版权声明：作者本人独立拥有该论文的版权，预印本系统仅拥有论文的永久保存权利。任何人未经允许不得重复使用。
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• 序号	提交日期	编号	操作
  1	2025-10-30	10.12201/bmr.202512.00010V1	下载

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