基于“一体两翼，疏调气机"探讨靶向治疗药物相关皮肤不良反应之病机演变及治疗

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[关键词]肿瘤；靶向治疗药物相关皮肤不良反应；一体两翼；疏调气机；中药；张震 [中图分类号]R273 [文献标志码]A [文章编号]doi：10.3969/j.issn.1674-070X.2026.01.016

[Abstract]Basedonthetheoryof"onebodywithtwo wings，regulatingand harmonizingqi movement"proposedby National TCM Master ZHANGZhen，thisstudyexploresthepathogenesisevolutionpaternsandstage-baseddiferentiationandtreatment strategiesforskinadversereactionsrelatedtotargetedtherapydrugs.Itisbelievedthattheorepathogenesisofteseskiadverse reactionsisqimovementdisordercausedbytheinvasionofdrugtoxins.Thediseaseprogresesalong thepathwayof"qistagnation withintensetoarth splen）strutionistagnattinolteralencyihlngingto，tatisxogeose trigerliverqiagationdoxicpatogesiiiallckeinndmusles;verqagtionfectsthsplenedingo theprodutionofdampnessandtoxicturbidityaccumulatesintheskin;prolongedilnessafectsthekidneyandinvadesthe colaterals，esultinginastubbocombiationoftoxinandbloodstasistatisdiffculttoresolve.Basedontisundersandinga stage-baseddiferentiationandtreatmentplanisestablished：Intheearlystage，thetreatmentfocusesonsothingtheliverand regulatingqitoexpelpathogenicfactors，clearingheatandremovingtoxinstoprotecttheskin;intemidlesage，theephasisis onsoothingtheliverandinvigoratingthespleentoresolveturbidity，removingtoxinsanddrainingdampnesstoharmonizethe Ying-nutrientsandWeidefence;inhelatestage，thereatmentaimstotonifythekidneyandreplenishesencetostrengthenthe foundation，activatebloodandunblockthecolateralstoeliminatelatenttoxins.Thisstudyaimstoprovidenewideasand theoreticalevidenceforthe preventionand treatmentof skin adversereactionsrelated to targeted therapydrugs using TCM.

[Keywords]tumor;skinadversereactionsrelatedtotargetedtherapeuticdrugs;onebodywithtwowings;regulatingand harmonizing qi movement; Chinese medicines； ZHANG Zhen

靶向治疗药物相关皮肤不良反应指肿瘤患者接受表皮生长因子受体（epidermal growth factor recep-tor，EGFR）抑制剂、血管内皮生长因子受体抑制剂、B-Raf原癌基因丝氨酸/苏氨酸激酶（B-Rafproto-oncogeneserine/threoninekinase，BRAF抑制剂等治疗后，因药物特异性干扰皮肤信号通路，导致毛囊、皮脂腺等功能障碍而引起炎症或屏障损伤的皮肤毒性反应。（剩余10664字）