1.Management of Cutaneous Immune-Related Adverse Events of Malignant Tumors Induced by Immune Checkpoint Inhibitors Based on Theory of "Fire and Original Qi are Restricted"
Shiliang SHAO ; Lijing JIAO ; Yichao WANG ; Decai WANG ; Qishan HUA ; Yabin GONG ; Ling XU
Journal of Traditional Chinese Medicine 2025;66(16):1656-1661
Guided by the theory of "fire and original qi are restricted", it is believed that original qi depletion is the root of the cutaneous immune-related adverse events (cirAEs) related to immune checkpoint inhibitors (ICIs), and the yin fire exuberance is the branch. Among them, original qi depletion is the internal foundation of the disease, while the drug toxicity of ICIs harming original qi is the initiating factor, and exuberant yin fire is the key pathogenesis. In clinical practice, the general treatment principle advocates banking up original qi to consolidate the root and draining fire to raise yang. Buzhong Yiqi Decoction (补中益气汤) can be used to activate transportation of middle jiao (焦) and promote ascent and dispersion of clear yang, thereby restoring the balance of qi and fire, and medicinals such as Huangqin (Radix Scutellariae), Huanglian (Rhizoma Coptidis) and Huangbai (Cortex Phellodendri Chinensis) can be supplementetd to clear and drain yin fire. At the same time, considering the accompanying symptoms such as dampness-stasis and fluids depletion, the methods of removing dampness and dispelling stasis, supplementing blood and nourishing yin should be added flexibly. This approach can provide a new perspective and treatment strategy for reducing ICIs-related cirAEs in malignant tumors.