通讯作者: 陈曦, fuzhoucxi@qq.com

DOI：10.12201/bmr.202601.00024

An Analysis of the Experience in Treating Irinotecan-Induced Delayed Diarrhea with the Method of Acrid Opening and Bitter Descending

• 摘要：伊立替康是治疗肿瘤的常用化疗药物，其所致腹泻是临床常见的剂量限制性毒性反应，严重影响治疗进程与患者生存质量。本病可归属于中医“泄泻”、“下利”范畴。吾师陈曦主任长期致力于中西医结合肿瘤临床与研究，认为本病核心病机在于癌毒内耗与药毒外袭二者相兼为患，导致脾胃虚弱，枢机失运，清浊不分而发为泄泻；其证多属寒热错杂、虚实互见。本文旨在浅析陈师运用辛开苦降法治疗此症的经验，并分享一例运用半夏泻心汤斡旋中焦气机、平调寒热、补泻兼施，成功治疗伊立替康所致腹泻的验案，以期为临床辨治此类并发症提供借鉴与思路。

  关键词： 伊立替康; 腹泻; 辛开苦降法; 半夏泻心汤

   

  Abstract: Irinotecan is a commonly used chemotherapeutic agent for the treatment of tumors, and the diarrhea it induces is a frequent dose-limiting toxicity in clinical practice, significantly impacting the treatment process and the quality of life of patients. This condition can be categorized under the traditional Chinese medicine (TCM) concepts of diarrhea and dysentery. Professor Chen Xi, who has long been dedicated to the clinical practice and research of integrated Chinese and Western medicine in oncology, posits that the core pathogenesis of this condition lies in the combined effects of internal consumption by cancer toxins and external assault by drug toxins, leading to spleen-stomach deficiency, impaired pivot mechanism, and the separation of the clear and turbid, resulting in diarrhea. The syndrome is often characterized by a mixture of cold and heat, as well as deficiency and excess. This article aims to provide a brief analysis of Professor Chens experience in treating this condition with the method of acrid opening and bitter descending, and to share a successful case where Banxia Xiexin Decoction was used to regulate the middle burner qi mechanism, balance cold and heat, and simultaneously tonify and purge, effectively treating Irinotecan-induced diarrhea. This case is intended to offer insights and approaches for the clinical differentiation and treatment of such complications.

  Key words: Irinotecan; Diarrhea; Method of Acrid Opening and Bitter Descending; Banxia Xiexin Decoction

  提交时间：2026-01-09

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• 序号	提交日期	编号	操作
  1	2025-11-24	10.12201/bmr.202601.00024V1	下载

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