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| 从络病理论探讨抗血管生成靶向药物相关性蛋白尿的辨治思路 |
| Discussion on the Differentiation and Treatment of Proteinuria Induced by Anti-Angiogenic Targeted Drugs Based on the Collateral Disease Theory |
| 投稿时间：2026-04-25 修订日期：2026-05-27 |
| DOI： |
| 中文关键词: 抗血管生成靶向药物 蛋白尿 络病理论 |
| 英文关键词:Anti-angiogenic targeted drugs Proteinuria Collateral disease theory |
| 基金项目:浙江省国医名师传承工作室建设项目吴良村国医名师传承工作室(No.GZS2021002)；第五批全国中医临床优秀人才研修项目(No.国中医药人教函[2022]1号) |
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| 中文摘要: |
| 抗血管生成靶向药物通过抑制血管内皮生长因子（Vascular Endothelial Growth Factor, VEGF）/血管内皮生长因子受体（Vascular Endothelial Growth Factor Receptor, VEGFR）阻断肿瘤血管新生，已成为实体瘤核心治疗策略，但因其干扰肾脏VEGF信号调控，引起足细胞裂孔隔膜屏障受损，肾小球内皮细胞凋亡，血栓性微血管病变，继发氧化应激反应等一系列病理过程，导致肾脏滤过屏障受损，造成蛋白尿等不良反应，常使治疗被迫中断。本文基于络病理论，将抗血管生成靶向药物相关性蛋白尿的核心病机归纳为“气络失充、血络瘀阻、络风内动”，系统探讨其中医病机与辨治思路，并结合典型医案进行佐证，为临床诊疗提供参考。 |
| 英文摘要: |
| Anti-angiogenic targeted drugs control tumor growth by inhibiting the Vascular Endothelial Growth Factor/Vascular Endothelial Growth Factor Receptor pathway, but their clinical use is often limited by adverse reactions such as proteinuria. Based on the collateral disease theory, this article proposes that the occurrence of proteinuria is closely related to "deficiency of qi-collaterals, stasis and obstruction of blood-collaterals, and internal stirring of collateral wind." It presents the synergistic treatment of supplementing deficiency to enrich collaterals, resolving stasis to unblock collaterals, and calming wind to pacify collaterals. Clinical case evidence supports its efficacy, providing a theoretical basis in traditional Chinese medicine and a new approach for the differentiation and treatment of targeted drug-related renal injury. |
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