肺纤维化中医病名、病机及证治规律探析
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摘要
肺纤维化是严重危害人类健康的疾病,一直是医学研究的难点之一。通过对历代中医关于"肺痿""肺痹""喘证""肺胀"等论述进行分析,结合近代中西医的研究成果,认为肺纤维化在病理、临床表现、病因病机及证治规律上都与肺痿、肺痹相似性很大,而与"喘证""肺胀"等几乎无关。肺纤维化的病名早期可归属于"肺痹",中期可归属于痹中有痿,痿中有痹,晚期可归属于"肺痿",可以根据其病因病机及证治规律来辨证论治。病机为气(阴)虚血瘀,治法常常融补肺、益阴、活血为一体,用养肺益气、养肺滋阴、养肺活血通络法来治疗肺纤维化。
Pulmonary fibrosis is a serious hazard to human health disease,has been one of the difficulties in medical research. By all previous dynasties Chinese medicine about"atrophic lung","pulmonary arthralgia"and"gasping syndrome""lung expansion"analysis,combined with modern research achievements of Chinese and Western medicine,thought in pathology,clinical manifestation,etiology and pathogenesis of pulmonary fibrosis and the governance law,pulmonary fibrosis with"atrophic lung""pulmonary arthralgia"similarity is very big,with"gasping syndrome""lung expansion"has little to do. Early diagnosis of pulmonary fibrosis can belongs to"pulmonary arthralgia",medium-term of pulmonary fibrosis can belongs to"pulmonary arthralgia"and"atrophic lung",the terminal of pulmonary fibrosis can belongs to"atrophic lung",this can root its etiology,pathogenesis,syndrome and treatment. Pathogenesis is Qi deficiency and blood stasis,often treating with filling lung,nourishing Yin,activating blood,with a method of tonifying Qi and nourishing Yin,promoting blood to treat pulmonary fibrosis.
Pulmonary fibrosis is a serious hazard to human health disease,has been one of the difficulties in medical research. By all previous dynasties Chinese medicine about"atrophic lung","pulmonary arthralgia"and"gasping syndrome""lung expansion"analysis,combined with modern research achievements of Chinese and Western medicine,thought in pathology,clinical manifestation,etiology and pathogenesis of pulmonary fibrosis and the governance law,pulmonary fibrosis with"atrophic lung""pulmonary arthralgia"similarity is very big,with"gasping syndrome""lung expansion"has little to do. Early diagnosis of pulmonary fibrosis can belongs to"pulmonary arthralgia",medium-term of pulmonary fibrosis can belongs to"pulmonary arthralgia"and"atrophic lung",the terminal of pulmonary fibrosis can belongs to"atrophic lung",this can root its etiology,pathogenesis,syndrome and treatment. Pathogenesis is Qi deficiency and blood stasis,often treating with filling lung,nourishing Yin,activating blood,with a method of tonifying Qi and nourishing Yin,promoting blood to treat pulmonary fibrosis.
引文
[1]Higashiyama H,Yoshimoto D,Okamoto Y,et al.Receptor activated Smad localization in bleomycin-induced pulmonary fibrosis[J].J Clin Pathol,2007,60(3):283-289.
[2]薛晓明,赵勤萍,王鹏.肺间质纤维化的中医药治疗进展[J].湖北中医杂志,2010,32(4):76-78.
[3]朱泽浩.替米沙坦治疗特发性肺纤维化效果观察[J].中国乡村医药,2011(11):24.
[4]韩萍.浅谈特发性肺纤维化的中医证治[J].现代中医药,2009,29(5):35.
[5]李戎,肖小花,刘春涛,吴曦.古代医家论肺痿之病名、病机及证候[J].上海中医药杂志,2011(11):30-31.
[6]疏欣杨,黄振国,李勇,等.肺痿冲剂方治疗特发性肺纤维化前后高分辨率CT比较研究[J].中华中医药杂志,2013(6):28-29.
[7]杨华,米烈汉.抗纤汤治疗肺纤维化疗效观察[J].陕西中医,2009(4):387-389.
[8]常继亭,杨华.抗纤汤治疗肺纤维化19例[J].陕西中医学院学报,2010(5):39-40.
[9]李蓉.李洪成辨证治疗特发性肺纤维化经验[J].河北中医,2011,33(1):11-12.
[10]任锋萍,王利民.丹红注射液治疗特发性肺纤维化的药理作用及安全性分析[J].中国现代医生,2012,50(11):140-141.
[11]董振华.从《内经》五脏痹理论探讨风湿病多系统损害的治疗[J].北京中医,2006,25(6):347-350.
[12]金晓光,代华平,庞宝森,等.博来霉素致大鼠肺纤维化模型肺组织的动态病理变化及其发生机制[J].中国病理生理杂志,2009,25(4):708.
[13]李辉,代媛媛,李国勤,等.重温肺痿肺痹文献,探讨特发性肺间质纤维化治疗[J].北京中医药,2011,29(11):839.
[14]曹振华,韩迪,张碧海,等.通络化纤颗粒治疗间质性肺纤维化60例临床观察[J].黑龙江中医药,2010(2):22-23.
[15]肖小花,李戎,梁繁荣,等.论中医“肺痿”一名与“肺纤维化”最为相侔[J].辽宁中医杂志,2012(6):1045-1047.
[16]崔永华.肺间质纤维化的中医证治探讨[J].中国中医急证,2006,15(8):878.
[17]于国强,吕晓东.吕晓东主任医师治疗肺纤维化经验[J].实用中医内科杂志,2007(2):20.
[18]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.
[19]高春芳,陆伦根,洪微,等.纤维化疾病的基础和临床[M].上海:上海科学技术出版社,2004:460.
[20]晏军.肺间质纤维化的“肺络癥瘕”观[J].中国中医基础医学杂志,2012,18(10):1069-1070
[21]郭素芳.中医药疗法在特发性肺纤维化治疗中的应用[J].中国中医药杂志,2008,15(2):90-91
[22]龚婕宁.论肺纤维化与养肺活血法[J].中国中医基础医学杂志,2005,11(10):759-761.
[2]薛晓明,赵勤萍,王鹏.肺间质纤维化的中医药治疗进展[J].湖北中医杂志,2010,32(4):76-78.
[3]朱泽浩.替米沙坦治疗特发性肺纤维化效果观察[J].中国乡村医药,2011(11):24.
[4]韩萍.浅谈特发性肺纤维化的中医证治[J].现代中医药,2009,29(5):35.
[5]李戎,肖小花,刘春涛,吴曦.古代医家论肺痿之病名、病机及证候[J].上海中医药杂志,2011(11):30-31.
[6]疏欣杨,黄振国,李勇,等.肺痿冲剂方治疗特发性肺纤维化前后高分辨率CT比较研究[J].中华中医药杂志,2013(6):28-29.
[7]杨华,米烈汉.抗纤汤治疗肺纤维化疗效观察[J].陕西中医,2009(4):387-389.
[8]常继亭,杨华.抗纤汤治疗肺纤维化19例[J].陕西中医学院学报,2010(5):39-40.
[9]李蓉.李洪成辨证治疗特发性肺纤维化经验[J].河北中医,2011,33(1):11-12.
[10]任锋萍,王利民.丹红注射液治疗特发性肺纤维化的药理作用及安全性分析[J].中国现代医生,2012,50(11):140-141.
[11]董振华.从《内经》五脏痹理论探讨风湿病多系统损害的治疗[J].北京中医,2006,25(6):347-350.
[12]金晓光,代华平,庞宝森,等.博来霉素致大鼠肺纤维化模型肺组织的动态病理变化及其发生机制[J].中国病理生理杂志,2009,25(4):708.
[13]李辉,代媛媛,李国勤,等.重温肺痿肺痹文献,探讨特发性肺间质纤维化治疗[J].北京中医药,2011,29(11):839.
[14]曹振华,韩迪,张碧海,等.通络化纤颗粒治疗间质性肺纤维化60例临床观察[J].黑龙江中医药,2010(2):22-23.
[15]肖小花,李戎,梁繁荣,等.论中医“肺痿”一名与“肺纤维化”最为相侔[J].辽宁中医杂志,2012(6):1045-1047.
[16]崔永华.肺间质纤维化的中医证治探讨[J].中国中医急证,2006,15(8):878.
[17]于国强,吕晓东.吕晓东主任医师治疗肺纤维化经验[J].实用中医内科杂志,2007(2):20.
[18]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.
[19]高春芳,陆伦根,洪微,等.纤维化疾病的基础和临床[M].上海:上海科学技术出版社,2004:460.
[20]晏军.肺间质纤维化的“肺络癥瘕”观[J].中国中医基础医学杂志,2012,18(10):1069-1070
[21]郭素芳.中医药疗法在特发性肺纤维化治疗中的应用[J].中国中医药杂志,2008,15(2):90-91
[22]龚婕宁.论肺纤维化与养肺活血法[J].中国中医基础医学杂志,2005,11(10):759-761.