清肺解毒、化痰散瘀辨治肺炎性假瘤(咳嗽)2月内占位影像消失1例报告
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摘要
肺炎性假瘤可能与免疫因素(变态反应),与抗生素的大量使用或滥用有关。症状及X线、CT表现很难与肺癌相鉴别,极易误诊,西医治疗以手术为主,但有复发可能。从中医角度可归属为积聚范畴,与正气亏虚,外邪入侵,气机不畅,痰血搏结有关,临床诊治围绕痰凝血瘀为机理,治以消痰化瘀,清肺解毒,短期肺内瘤体消失,治疗效果佳,可为临床治疗提供有效方法。附验案1则。
Pulmonary inflammatory pseudotumor may be related to immune factors( allergy) and the use or abuse of antibiotics. Its symptoms,X-ray and CT manifestations are difficult to distinguish from lung cancer and it is easily misdiagnosed. Surgery is the main Western medicine treatment with a possibility of recurrence. From the perspective of traditional Chinese medicine,it can be classified as accumulation,related with deficiency of vital energy,invasion of exogenous pathogens,Qi movement obstruction,phlegm and blood stasis. Clinical diagnosis and treatment centers on the mechanism of eliminating phlegm and removing blood stasis,clearing the lung and detoxifyingso as to make short-term lung tumor disappear. Chinese medicine has a good therapeutic effect and provides an effective method for clinical treatment and there is oneclinical case in the paper.
Pulmonary inflammatory pseudotumor may be related to immune factors( allergy) and the use or abuse of antibiotics. Its symptoms,X-ray and CT manifestations are difficult to distinguish from lung cancer and it is easily misdiagnosed. Surgery is the main Western medicine treatment with a possibility of recurrence. From the perspective of traditional Chinese medicine,it can be classified as accumulation,related with deficiency of vital energy,invasion of exogenous pathogens,Qi movement obstruction,phlegm and blood stasis. Clinical diagnosis and treatment centers on the mechanism of eliminating phlegm and removing blood stasis,clearing the lung and detoxifyingso as to make short-term lung tumor disappear. Chinese medicine has a good therapeutic effect and provides an effective method for clinical treatment and there is oneclinical case in the paper.
引文
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[13]Matsuba ra O,T a n-Li u NS,Kenney RM,et al.1n flammatory pseudotumors of the 1ung:progression from oranizing pneumonia to fibrous histocytoma or to plasma cell granuloma in 32 cases[J].Hum Pathol,1988,19(7):807.
[14]张仲景.金匮要略方论[M].北京:人民卫生出版社,2012:45.
[15]沈金鳌.杂病源流犀烛[M].田思胜,整理.北京:人民卫生出版社,2006:426.
[16]国家药典委员会.中华人民共和国药典·2015年版·一部[S].北京:中国医药科技出版社,2015.
[17]浙江省食品药品监督管理局.浙江省中药炮制规范[M].北京:中国医药科技出版社,2015.
[2]白逸秋.肺炎性假瘤恶变[J].北京医学,1985,7(2):80-81.
[3]徐立阳,姜达志,杜嘉慧.肺炎性假瘤的诊断与手术治疗[J].临床肺科杂志,2009,14(11):1454.
[4]屈大望,张熙曾,苏延军,等.肺部炎性假瘤的临床诊治(附178例报告)[J].中国肿瘤临床,2000,27(6):455-457.
[5]施毅,陈正堂.现代呼吸病治疗学[M].北京:人民军医出版社,2002:530.
[6]Wen ZH,Zou XL,Yang G,et al.The radiologiealimage of pulmonary in flammatory pseudotumor:an analys is of 36 cases[J].ChineseGerman Journal of Clinical Oncology,2012,(11):153-155.
[7]吴志祥,刘韧.肺部炎性假瘤的诊断与外科治疗[J].医学临床研究,2009,26(7):1316-1317.
[8]Bahadori M,Liebow,AA.Plasma cell granulomas of the lung[J].Cancer,1973,31(1):191-193.
[9]金炜,袁军,肖祥之,等.肺炎性假瘤的临床特点和外科治疗[J].中国实用医药,2013,8(25):38-39.
[10]罗业春,陈永福.肺炎性假瘤45例临床分析[J].广西医学,2008,30(5):746-747.
[11]善秀红,郑金旭,彭卫斌,等.周围型肺癌与肺炎性假瘤的动态CT研究[J].实用放射学杂志,2005,2(1):26-27.
[12]刘广红.肺部炎性假瘤CT误诊29例分析[J].中国误诊学杂志,2007,7(5):1008-1009.
[13]Matsuba ra O,T a n-Li u NS,Kenney RM,et al.1n flammatory pseudotumors of the 1ung:progression from oranizing pneumonia to fibrous histocytoma or to plasma cell granuloma in 32 cases[J].Hum Pathol,1988,19(7):807.
[14]张仲景.金匮要略方论[M].北京:人民卫生出版社,2012:45.
[15]沈金鳌.杂病源流犀烛[M].田思胜,整理.北京:人民卫生出版社,2006:426.
[16]国家药典委员会.中华人民共和国药典·2015年版·一部[S].北京:中国医药科技出版社,2015.
[17]浙江省食品药品监督管理局.浙江省中药炮制规范[M].北京:中国医药科技出版社,2015.