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大方与小方治疗骨髓增生异常综合征探析

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骨髓增生异常综合征作为一种异质性克隆性血液系统疾病,临床中存在多种分型与不同的临床预后,因此在掌握病情变化的同时,个体化治疗十分重要.该病中医称"髓毒劳"以正虚邪实,虚、毒、瘀并存为病机特点,亦存在多种证型.整体观念与辨证论治是中医临床中的重要理念,该病以整体观念为背景,以辨证论治为核心,以临床疗效为最终目的,结合复杂病机特点会在临证组方中形成了大方与小方的差异,而大方与小方虽然作用不同,但各有侧重,均可通过君臣佐使的不同配伍形成对应正虚邪实复杂病机的临床疗效,实现在复杂的病情变化中动态且个体化的治疗,并取得良好疗效.
Analysis on Big and Minor Prescriptions in Treatment of Myelodysplastic Syndrome
As a heterogeneous clonal blood system disease,myelodysplastic syndrome has various clinical classifications and different clinical prognosis,so it is very important to master the changes of the disease and individualized treatment.The tradition-al Chinese medicine name for this disease is"medullary toxin fatigue",which is characterized by vital Qi deficiency and evil ex-cess and the coexistence of deficiency,toxin and blood stasis.There are also multiple syndrome types.The holistic concept and differentiation of symptoms and signs are important concepts in traditional Chinese medicine clinical practice.This disease is based on the holistic concept,with syndrome differentiation as the core,and the clinical efficacy as the ultimate goal.Combining the characteristics of complex pathogenesis,the difference between big and minor prescriptions can be formed in clinical prescrip-tions.Although the functions of big and minor prescriptions are different,each has its own emphasis,and can be formed through different combinations of monarch drugs,ministerial drugs and assisting drugs to form clinical therapeutic effects corresponding to the complex pathogenesis of vital Qi deficiency and evil excess,to achieve dynamic and personalized treatment in complex disease changes and obtain good therapeutic effects.

big prescriptionsminor prescriptionsmyelodysplastic syndromeoverall conceptsyndrome differentiation and treatment

毛悦、唐旭东

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北京中医药大学,北京 100029

中国中医科学院西苑医院血液科,北京 100091

大方 小方 骨髓增生异常综合征 整体观念 辨证论治

2025

辽宁中医杂志
辽宁中医药大学,辽宁省中医药学会

辽宁中医杂志

北大核心
影响因子:0.815
ISSN:1000-1719
年,卷(期):2025.52(1)