特发性肺间质纤维化相关喘证中医治疗策略
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摘要
特发性肺间质纤维化临床以进行性呼吸困难、进行性低氧血症、Velcro罗音、气不相续而致喘、同时伴刺激性干咳或伴少量黏痰为主要症状。研究团队系统梳理历代名医辨证施治喘证的用药治疗规律,并结合导师吕晓东教授近10年来,临床中医药治疗特发性肺间质纤维化的用药经验,从虚、寒、热、痰、饮等五类喘证为着眼点,治疗以益气养阴为主,化痰定喘、清热解毒为辅。制定出特发性肺间质纤维化相关喘证中医治疗策略,为中医临床治疗合理用药提供理论依据。
Idiopathic pulmonary interstitial fibrosis is characterized by progressive dyspnea,progressive hypoxemia,Velcro rales,wheezing due to inconsistent breathing,and irritating dry cough or a small amount of phlegm. The research team systematically combed the medication and treatment rules of asthma syndrome of famous doctors in past dynasties,and combined with Professor LYU Xiaodong's experience in treating idiopathic pulmonary interstitial fibrosis in the past 10 years,from five types of asthma syndrome such as asthenia,cold,heat,phlegm and drinking to focus on the treatment of tonifying Qi and nourishing Yin,resolving phlegm and relieving asthma and clearing heat and detoxifying is subsidiary. To formulate the TCM treatment strategy of idiopathic pulmonary interstitial fibrosis related asthma syndrome,and provide theoretical basis for the rational use of TCM in clinical treatment.
Idiopathic pulmonary interstitial fibrosis is characterized by progressive dyspnea,progressive hypoxemia,Velcro rales,wheezing due to inconsistent breathing,and irritating dry cough or a small amount of phlegm. The research team systematically combed the medication and treatment rules of asthma syndrome of famous doctors in past dynasties,and combined with Professor LYU Xiaodong's experience in treating idiopathic pulmonary interstitial fibrosis in the past 10 years,from five types of asthma syndrome such as asthenia,cold,heat,phlegm and drinking to focus on the treatment of tonifying Qi and nourishing Yin,resolving phlegm and relieving asthma and clearing heat and detoxifying is subsidiary. To formulate the TCM treatment strategy of idiopathic pulmonary interstitial fibrosis related asthma syndrome,and provide theoretical basis for the rational use of TCM in clinical treatment.
引文
[1]赵艳玲,赵克明,郑忻.中药复方治疗特发性肺间质纤维化的临床研究[J].世界中西医结合杂志,2013,8(12):1226-1228.
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[3]李晓侠,马健.小儿清肺化痰口服液辅治痰热壅肺型小儿急性支气管炎疗效观察[J].现代中西医结合杂志,2016,25(20):2204-2206.
[4]郭建波,常宇菲,张伟.黄龙苏葶散治疗小儿喘息性支气管炎(痰热壅肺证)疗效观察[J].中医药信息,2017,34(1):101-103.
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[9]袁佺,庞立健,滑振,等.基于络病理论的特发性肺纤维化“肺气阴虚、痰瘀伏络”病机探微[J].中国中医基础医学杂志,2014,20(7):893-921.
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[11]吕晓东.参龙煎剂治疗肺间质纤维化27例临床效果观察[J].临床心身疾病杂志,2007,13(2):1.
[12]薛鸿浩,张惠勇,王巍.益气养阴、散结化瘀方治疗特发性肺纤维化22例[J].光明中医,2017,32(4):505-507.
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[14]李琳.喘证中医辨治探析[J].亚太传统医药,2010,6(1):47-48.
[15]韩翠宁.补肾纳气散加减治疗虚喘证54例疗效观察[J].临床医学研究与实践,2018,1(3):127-128.
[16]李鹏,李群.中医药治疗热喘病32例临床观察[J].哈尔滨医药,2010,30(1):45-46.
[17]刘淼,廖尖兵,王文譞,等.基于“治痿独取阳明”论治特发性肺纤维化[J].中华中医药学刊,2018,36(6):1414-1416.
[18]冷萍,张平云,苏婷,等.基于气机变化理论对特发性肺纤维化的病机探讨[J].中华中医药学刊,2017,35(9):2332-2334.
[19]徐昌君,王鹏飞,黄雅薇,等.黄芪总黄酮对特发性肺纤维化miRNA-21、let-7d及TGF-β/smad信号干预作用[J].中华中医药学刊,2018,36(6):1308-1311.
[20]陈子秋.补肾益肺化纤方联合泼尼松对特发性肺纤维化患者血清纤维化相关指标及生命质量的影响[J].四川中医,2017,35(6):70-72.
[21]王志超,武琦,冯凡超,等.血管紧张素抑制药联合糖皮质激素对特发性肺纤维化作用的系统评价[J].中国临床药理学杂志,2017,33(21):2182-2186.
[22]雷凯春,岳红梅,周婷婷.吡非尼酮治疗特发性肺纤维化的临床疗效及不良反应[J].中国新药与临床杂志,2018,37(3):160-163.
[23]刘锐,叶传冬,雷宁宁.中药治疗特发性肺纤维化的临床研究近况[J].国际中医中药杂志,2017,39(6):570-572.
[2]李艳艳,张燕萍,王书臣,等.益气通络法治疗肺络痹阻、气阴两虚型特发性肺纤维化的临床研究[J].时珍国医国药,2014,25(3):530-632.
[3]李晓侠,马健.小儿清肺化痰口服液辅治痰热壅肺型小儿急性支气管炎疗效观察[J].现代中西医结合杂志,2016,25(20):2204-2206.
[4]郭建波,常宇菲,张伟.黄龙苏葶散治疗小儿喘息性支气管炎(痰热壅肺证)疗效观察[J].中医药信息,2017,34(1):101-103.
[5]郭章华.仲景经方治喘临床应用述评[J].吉林中医药,2013,10(10):1075.
[6]刘创,庞立健,吕晓东.特发性肺纤维化“肺虚络瘀”病机发微[J].上海中医药杂志,2014,48(3):22-24.
[7]刘旻,赵启亮,刘贵颖.中药治疗特发性肺纤维化103例生存预后的回顾性分析[J].世界中西医结合杂志,2015,10(2):229-232.
[8]韩素恒,刘妮波,郝彧,等.中医药治疗特发性肺纤维化的文献计量学分析[J].中医药导报,2016,22(13):64-67.
[9]袁佺,庞立健,滑振,等.基于络病理论的特发性肺纤维化“肺气阴虚、痰瘀伏络”病机探微[J].中国中医基础医学杂志,2014,20(7):893-921.
[10]崔红生,陈会娟,武维屏.试论通法在肺系疾病中的应用[J].北京中医药大学学报,2013,36(4):286-288.
[11]吕晓东.参龙煎剂治疗肺间质纤维化27例临床效果观察[J].临床心身疾病杂志,2007,13(2):1.
[12]薛鸿浩,张惠勇,王巍.益气养阴、散结化瘀方治疗特发性肺纤维化22例[J].光明中医,2017,32(4):505-507.
[13]刘赟,樊茂蓉,张燕萍.张燕萍治疗特发性肺纤维化经验[J].北京中医药,2014(4):267-268.
[14]李琳.喘证中医辨治探析[J].亚太传统医药,2010,6(1):47-48.
[15]韩翠宁.补肾纳气散加减治疗虚喘证54例疗效观察[J].临床医学研究与实践,2018,1(3):127-128.
[16]李鹏,李群.中医药治疗热喘病32例临床观察[J].哈尔滨医药,2010,30(1):45-46.
[17]刘淼,廖尖兵,王文譞,等.基于“治痿独取阳明”论治特发性肺纤维化[J].中华中医药学刊,2018,36(6):1414-1416.
[18]冷萍,张平云,苏婷,等.基于气机变化理论对特发性肺纤维化的病机探讨[J].中华中医药学刊,2017,35(9):2332-2334.
[19]徐昌君,王鹏飞,黄雅薇,等.黄芪总黄酮对特发性肺纤维化miRNA-21、let-7d及TGF-β/smad信号干预作用[J].中华中医药学刊,2018,36(6):1308-1311.
[20]陈子秋.补肾益肺化纤方联合泼尼松对特发性肺纤维化患者血清纤维化相关指标及生命质量的影响[J].四川中医,2017,35(6):70-72.
[21]王志超,武琦,冯凡超,等.血管紧张素抑制药联合糖皮质激素对特发性肺纤维化作用的系统评价[J].中国临床药理学杂志,2017,33(21):2182-2186.
[22]雷凯春,岳红梅,周婷婷.吡非尼酮治疗特发性肺纤维化的临床疗效及不良反应[J].中国新药与临床杂志,2018,37(3):160-163.
[23]刘锐,叶传冬,雷宁宁.中药治疗特发性肺纤维化的临床研究近况[J].国际中医中药杂志,2017,39(6):570-572.