林丽珠辨治表皮生长因子受体抑制剂相关皮疹的经验探析

目的：总结林丽珠教授对EGFRIs皮疹病因病机的认识及辨治疗效。方法：28例患者中治疗组17例，予荆防四物汤＋皮肤外洗方治疗EGFRIs所致皮疹，空白对照组11例。观察两组前后皮肤毒性分级变化，评估治疗组药疹治疗效果，并比较半年后EGFRIs疗效及患者生存情况。结果：治疗组17例，痊愈0例，好转15例，无效2例，总有效率88．24％。治疗后主观症状显著改善（P〈0．01）；发疹密度下降，尤其是脓疱样皮疹出现减少；风热型、胃热型比其它证型疗效更佳（P〈0．05）；半年后随访两组在GFRIs疗效上无显著统计学差异（P〉0．05）。结论：本方案辨证加减治疗EGFRIs相关皮疹有确切的疗效，加用中药辨证治疗半年内对EGFRIs疗效无明显影响。

Dermatological Toxicities to EGFR Inhibitors:Professor Lin Lizhu's Treatment Experience Based on Syndrome Differentiation in TCM

This work tried to summarize Professor Lin Lizhu＇s experience about the etiology and pathogensis, as well as efficacy in TCM of drug eruption caused by EGFRIs. Of the 28 cases selected, 17 were classed into the TCM-treatment group and received the Chinese medicine therapy of Chizonepeta and Ledebouriella Four Agents Decoction and Skin-Wash Lotion. The other 11 cases were classed into the blank control group for evaluating the efficacy of the Chinese medicine. The patient survival status and the anti-tumor efficacy of EGFRIs were compared after six months to observe whether the Chinese medicine had any effect. For the TCM-treatment group, no one was cured, 15 cases were improved, and 2 cases were ineffective, with the total effective rate up to 88.24%; rash density decreased, and the symptoms were markedly alleviated （P 〈0.01 ）, especially for the Wind-Heat Type and the Stomach-Heat Type （P 〉 0.05 ）. No significant statistic difference was observed in the EGFRIs treatment for the two groups （P 〉0.05）.The results showed that the TCM therapy has definite therapeutic effect on drug eruption caused by EGFRIs, and it has no significant impact on the anti-tumor efficacy of EGFRIs in six months.