摘要
李国勤教授认为支气管扩张症临床上可分为急性发作期和迁延缓解期。急性发作期可分为痰热壅肺、肝火犯肺、热伤肺络等证;缓解期可分为肺气阴两虚、肺脾两虚等证。治疗上急性期以清热化痰、清肝凉血、清热养阴为主,缓解期以益气养阴、润肺止咳、健脾化痰、活血化瘀为主。李国勤教授治疗上分期辨治,擅用清法,兼顾血证,顾护脾胃,辅以扶正,临床上获得了较好的疗效。
Professor Li Guoqin proposes that bronchiectasis can be divided into acute exacerbation stage and clinical remission stage. Acute exacerbation stage can be divided into syndrome of phlegm-heat obstructing lung, syndrome of liver fire invading lung, syndrome of lung collaterals injured by heat, and so on; clinical remission period can be divided into syndrome of deficiency of both qi and yin of lung, deficiency of both lung and spleen, and so on. Aimed at the treatment of acute stage, he mainly uses the methods of clearing heat and dissipating phlegm, clearing liver and cooling blood, clearing heat and nourishing yin. Aimed at remission stage, he mainly uses the methods of benefiting qi and nourishing yin, moistening lung for arresting cough, invigorating the spleen and eliminating phlegm, promoting blood circulation for removing blood stasis. Professor Li Guoqin uses treatment based on different stages, he is good at clearing method, gives consideration to blood syndrome, takes care of the spleen and stomach, supplemented by strengthening vital qi, and he has achieved a good effect in clinic.
引文
[1]Smith MP.Diagnosis and management of bronchiectasis[J]CMAJ,2017,189(24):E828-E835.
[2]成人支气管扩张症诊治专家共识编写组.成人支气管扩张症诊治专家共识[J].中华结核和呼吸杂志,2012,35(7):485-492.
[3]徐小勇,施毅.支气管扩张的诊断和治疗进展[J].中国呼吸与危重监护杂志,2017,16(2):186-190.
[4]Polverino E,Goeminne PC,McDonnell MJ,et al.European Respiratory Society guidelines for the management of adult bronchiectasis[J].Eur Respir J,2017,50(3):1700629.
[5]李新如,张明洋,喻昌利,等.成人支气管扩张症患者焦虑抑郁情绪的影响因素及其与生活质量的关系[J].临床荟萃,2018,33(10):918-920.
[6]顾颖军,龚正华,施磊,等.苇茎汤对老年性肺炎相关血清炎症因子及免疫功能的影响[J].中国中医急症,2018,27(4):676-678.
[7]王慧玲,李越华.中药治疗脓毒症研究进展[J].山东中医杂志,2016,35(2):175-177.
[8]王瑞,刘圣金,吴德康,等.青礞石对AECOPD痰热证模型大鼠血清及肺组织中炎症因子的影响[J].中药材,2015,38(10):2148-2151.
[9]李景丽,杨宏乔,刘静,等.乌梅生品及其不同制炭品止血作用的对比研究[J].陕西中医,2014,35(12):1680-1681.
[10]张丹丹,马锦地,李建生,等.基于现代名老中医经验的风温肺热病常见证候方药规律研究[J].中国中医基础医学杂志,2017,23(9):1298-1301.
[11]王冰,苗青,王书臣,等.王书臣治疗支气管扩张症经验[J].中医杂志,2017,58(8):647-650.
[12]邵晶,杜丽东,吴国泰,等.煎煮形式及配伍比例对党参黄芪复方免疫调节作用的影响[J].中国临床药理学杂志,2017,33(10):917-938.
[13]王凯,张伯礼,崔远武,等.桔梗“载药上行”探寻与评议[J].中医杂志,2018,59(4):271-275.
[14]罗慧,张立山,武维屏.武维屏教授治疗支气管扩张经验[J].中华中医药杂志,2014,29(3):783-785.
[15]廖爱军,张丽杰,刘卓刚.中药补络补管汤止血机制的实验研究[J].成都中医药大学学报,2006,29(2):34-36.
[16]袁莎莎,马冲,苗青,等.支气管扩张症的全程管理及中医诊治思路探讨[J].中医杂志,2018,59(18):1560-1573.
[17]郭强,许爱英.“补而不滞”在补益剂配伍中的应用及临床意义[J].陕西中医学院学报,2009,32(1):53-54.
[18]杨佩兰,黄海茵,吴银根,等.扶正化痰清热法治疗支气管扩张症46例远期疗效观察[J].中医杂志,2012,53(10):848-852.
[19]郭灵龙,李忠军,张松.张恩树应用花蕊石治疗咯血验案[J].实用中医药杂志,2018,34(7):854.
[20]王新民.白及粉冲服对支气管扩张咯血治疗的作用机制研究[J].黑龙江中医药,2017,46(4):11-12.
