慢性阻塞性肺疾病与肺胀
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摘要
慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD,以下简称慢阻肺)和肺胀在定义、分期、症状和治疗等方面均有相通之处,中医和西医作为两种不同的医学体系,中医在整体调理、辨证施治等方面有显著优势,现代医学则在疾病发病机制及一些检查方法、治疗手段上有明显优势,经过中西医双诊双治的融合,必将更好的诊治。因此,在临床实践中,在立足中医的前提下,积极借鉴现代医学的相关知识,关注呼吸道症状的同时,亦关注无明显症状的高危人群,并积极探寻敏感性、特异性高的诊断指标,提高慢阻肺的早期诊断率,坚持辨病与辨证相结合的基本原则下辨证论治,探索出更加适合慢阻肺患者的个体化诊疗方案。
Chronic obstructive pulmonary disease(COPD) and pulmonary distention have similarities in terms of disease definition,disease stage,disease integrity and lung rehabilitation. Although TCM and Western medicine are two different medical systems,TCM has significant advantages in overall conditioning,syndrome differentiation and treatment. Modern medicine has developed rapidly in the pathogenesis of diseases,some methods of examination and treatment. Therefore,it is necessary to integrate TCM with Western medicine. On the premise of syndrome differentiation and treatment of TCM,we should actively draw on the relevant knowledge of modern medicine,pay attention to respiratory symptoms,and at the same time pay attention to the high-risk groups without obvious symptoms. We should also actively explore the diagnostic indicators with high sensitivity and specificity,improve the early diagnostic rate of COPD,and explore more suitable individualized strategy of diagnosis and treatment for COPD in China.
Chronic obstructive pulmonary disease(COPD) and pulmonary distention have similarities in terms of disease definition,disease stage,disease integrity and lung rehabilitation. Although TCM and Western medicine are two different medical systems,TCM has significant advantages in overall conditioning,syndrome differentiation and treatment. Modern medicine has developed rapidly in the pathogenesis of diseases,some methods of examination and treatment. Therefore,it is necessary to integrate TCM with Western medicine. On the premise of syndrome differentiation and treatment of TCM,we should actively draw on the relevant knowledge of modern medicine,pay attention to respiratory symptoms,and at the same time pay attention to the high-risk groups without obvious symptoms. We should also actively explore the diagnostic indicators with high sensitivity and specificity,improve the early diagnostic rate of COPD,and explore more suitable individualized strategy of diagnosis and treatment for COPD in China.
引文
[1]陈亚红.2017年GOLD慢性阻塞性肺疾病诊断、治疗及预防的全球策略解读[J].中国医学前沿杂志,2017,9(1):37-47.
[2]WANG CHEN.Prevalence and risk factors of chronic obstructive pulmonary disease in China(the China Pulmonary Health study):a national cross-sectional study[J].Lancet,2018,391(8):20-28.
[3]SUISSA S,DELL ANIELLO S,ERNST P.Long-term natural history of chronic obstructive pulmonary disease:severe exacerbations and mortality[J].Thorax,2012,67(11):957-963.
[4]陈宪海,陈召华,周钦荣.《诸病源候论》论治肺胀特色及对现代临床的启示[J].中华中医药学刊,2010,29(3):503-505.
[5]林先刚,朱睿,刘自兵.COPD与黏液高分泌研究进展[J].内蒙古中医药,2017,36(12):140-141.
[6]马珍荣.肺呼吸康复治疗对缓解期危重度慢性阻塞性肺病患者的临床分析[J].双足与保健,2018,27(2):58-60.
[7]张兴彩,蔡余力,张伟,等.二十四式太极拳及呼吸功能训练辅助西药对慢性阻塞性肺疾病稳定期患者的影响[J].中医杂志,2014,55(22):1937-1941.
[8]王晓慧.早期肺康复训练在有创机械通气患者中的应用价值分析[J].中国继续医学教育,2018,10(8):153-154.
[9]张荣葆,谭星宇,何权瀛.从流行病学调查结果看我国慢性阻塞性肺疾病诊断不足问题[J].中华健康管理学杂志,2013,7(1):44-47.
[10]AGUSTI A,CALVERLEY P M,CELLI B,et al.Characterisation of COPD heterogeneity in the ECLIPSE cohort.[J].Respiratory Research,2010,11(1):122-132.
[11]GROUSE L.New studies address urgent need for early COPD diagnosis[J].Journal of Thoracic Disease,2012,4(1):19-21.
[12]张小娥,张彩莲.早期慢性阻塞性肺疾病研究进展[J].临床误诊误治,2017,30(6):112-116.
[13]陈宪海,张兴彩,贾新华,等.早期干预慢性阻塞性肺疾病的中医学思考[J].中华中医药学刊,2012,31(8):1711-1713.
[14]朱雪,李珂,陈宪海,等.玉屏风散对煤烟相关可吸入颗粒物致肺损伤模型小鼠免疫功能的干预作用[J].中国实验方剂学杂志,2018,24(8):103-109.
[15]张兴彩,蔡余力,张伟,等.中医痰湿体质与慢性阻塞性肺疾病相关性研究[J].中医研究,2013,26(10):13-15.
[16]郭永洁.中医临证辨证思路与方法[J].上海中医药杂志,2007,41(10):42-43.
[17]尹常健.穿越时空的科学碰撞与交融[N].中国中医药报,2016-04-22(003).
[18]于凌军,陈宪海.浅述慢性阻塞性肺疾病急性加重期中医病因病机研究[J].陕西中医学院学报,2013,36(3):117-118.
[19]朱笑笑.陈宪海辨证分型辨治慢性阻塞性肺疾病稳定期[J].实用中医内科杂志,2016,30(6):20-22.
[2]WANG CHEN.Prevalence and risk factors of chronic obstructive pulmonary disease in China(the China Pulmonary Health study):a national cross-sectional study[J].Lancet,2018,391(8):20-28.
[3]SUISSA S,DELL ANIELLO S,ERNST P.Long-term natural history of chronic obstructive pulmonary disease:severe exacerbations and mortality[J].Thorax,2012,67(11):957-963.
[4]陈宪海,陈召华,周钦荣.《诸病源候论》论治肺胀特色及对现代临床的启示[J].中华中医药学刊,2010,29(3):503-505.
[5]林先刚,朱睿,刘自兵.COPD与黏液高分泌研究进展[J].内蒙古中医药,2017,36(12):140-141.
[6]马珍荣.肺呼吸康复治疗对缓解期危重度慢性阻塞性肺病患者的临床分析[J].双足与保健,2018,27(2):58-60.
[7]张兴彩,蔡余力,张伟,等.二十四式太极拳及呼吸功能训练辅助西药对慢性阻塞性肺疾病稳定期患者的影响[J].中医杂志,2014,55(22):1937-1941.
[8]王晓慧.早期肺康复训练在有创机械通气患者中的应用价值分析[J].中国继续医学教育,2018,10(8):153-154.
[9]张荣葆,谭星宇,何权瀛.从流行病学调查结果看我国慢性阻塞性肺疾病诊断不足问题[J].中华健康管理学杂志,2013,7(1):44-47.
[10]AGUSTI A,CALVERLEY P M,CELLI B,et al.Characterisation of COPD heterogeneity in the ECLIPSE cohort.[J].Respiratory Research,2010,11(1):122-132.
[11]GROUSE L.New studies address urgent need for early COPD diagnosis[J].Journal of Thoracic Disease,2012,4(1):19-21.
[12]张小娥,张彩莲.早期慢性阻塞性肺疾病研究进展[J].临床误诊误治,2017,30(6):112-116.
[13]陈宪海,张兴彩,贾新华,等.早期干预慢性阻塞性肺疾病的中医学思考[J].中华中医药学刊,2012,31(8):1711-1713.
[14]朱雪,李珂,陈宪海,等.玉屏风散对煤烟相关可吸入颗粒物致肺损伤模型小鼠免疫功能的干预作用[J].中国实验方剂学杂志,2018,24(8):103-109.
[15]张兴彩,蔡余力,张伟,等.中医痰湿体质与慢性阻塞性肺疾病相关性研究[J].中医研究,2013,26(10):13-15.
[16]郭永洁.中医临证辨证思路与方法[J].上海中医药杂志,2007,41(10):42-43.
[17]尹常健.穿越时空的科学碰撞与交融[N].中国中医药报,2016-04-22(003).
[18]于凌军,陈宪海.浅述慢性阻塞性肺疾病急性加重期中医病因病机研究[J].陕西中医学院学报,2013,36(3):117-118.
[19]朱笑笑.陈宪海辨证分型辨治慢性阻塞性肺疾病稳定期[J].实用中医内科杂志,2016,30(6):20-22.