哮喘-慢阻肺重叠的中医辨治思路
|
摘要
介绍孙子凯主任医师辨治哮喘-慢阻肺重叠(ACO)的经验。哮喘-慢阻肺重叠较单纯哮喘或慢阻肺而言,治疗难度更大,预后更差。孙老师强调肺脾肾亏虚是发病之本,痰饮为标,感受外邪是诱发因素。辨治应紧密结合病机特点,发时治肺,辨痰为要,兼顾其本;平时治本,补中益气,温阳固肾。用药精当,组方灵活,才能收获满意疗效。
The experience of chief physician SUN Zikai in treating of asthma-chronic obstructive pulmonary disease overlap(ACO) was introduced. ACO is more difficult to treat and has a worse prognosis than either asthma or chronic obstructive pulmonary disease. Teacher SUN emphasized that the deficiency of lung, spleen and kidney is the root cause of the disease, and phlegm is the manifestation, and contracting the external pathogen is the inducing factor. Combined with the characteristics of pathogenesis, treating the lung at the time of onset, differentiating phlegm is essential, taking into account its root cause. In alleviating period, treating the root cause, invigorating spleen-stomach and replenishing Qi, warming Yang and invigorating the kidney, with excellent medication, flexible prescription and with satisfactory results.
The experience of chief physician SUN Zikai in treating of asthma-chronic obstructive pulmonary disease overlap(ACO) was introduced. ACO is more difficult to treat and has a worse prognosis than either asthma or chronic obstructive pulmonary disease. Teacher SUN emphasized that the deficiency of lung, spleen and kidney is the root cause of the disease, and phlegm is the manifestation, and contracting the external pathogen is the inducing factor. Combined with the characteristics of pathogenesis, treating the lung at the time of onset, differentiating phlegm is essential, taking into account its root cause. In alleviating period, treating the root cause, invigorating spleen-stomach and replenishing Qi, warming Yang and invigorating the kidney, with excellent medication, flexible prescription and with satisfactory results.
引文
[1]万敏,唐小婷,张巧,等.哮喘-慢阻肺重叠综合征患者240例临床特征分析[J].第三军医大学学报,2015,37(21):2181-2185.
[2]孙婉璐,陈亚红.2016版全球哮喘防治创议更新简介[J].中国医学前沿杂志(电子版),2016,8(7):33-40.
[3]廉洁,潘殿柱.哮喘-慢性阻塞性肺病重叠综合征发病机制研究进展[J].辽宁医学院学报,2016,37(5):107-109.
[4]陈石,李磊,吴刚,等.吸入激素联合噻托溴铵治疗哮喘-慢阻肺重叠综合症的临床疗效评价[J].临床肺科杂志,2015,20(10):1856-1860.
[5]LOUIE S,ZEKI AA,SCHIVO M,et al.The asthma-chronic obstructive pulmonary disease overlap syndrome:pharmacotherapeutic considerations.Expert Rev Clin Pharmacol,2013,6(2):197-219.
[6]DIAZ-GUZMAN E,KHOSRAVI M,MANNINO D M.Asthma,chronic obstructive pulmonary disease,and mortality in the U.S.population.COPD,2011,8(6):400-407.
[7]孙永昌.哮喘-慢阻肺重叠综合征指南解读[J].中国呼吸与危重监护杂志,2014,13(4):325-329.
[8]李雯雯,朱雪,郭梦倩,等.论风邪在多种呼吸系统疾病发病机制中的重要作用[J].时珍国医国药,2013,24(11):2738-2739.
[9]王付.小青龙汤方证及变证与衍生方的应用[J].中医杂志,2013,54(22):1908-1910,1925.
[10]戴晓新,洪旭初.慢阻肺-哮喘重叠综合征及药物治疗现状[J].实用医学杂志,2014,30(14):2189-2190.
[11]孙子凯.金陵名医曹世宏治疗肺系疾病经验[J].中华中医药杂志,2017,32(1):190-193.
[12]王丽华,张元兵,兰智慧,等.国医大师洪广祥教授治疗慢性阻塞性肺疾病经验[J].中华中医药杂志,2016,31(7):2590-2592.
[13]吴瑶,王飞,王全林,等.慢性阻塞性肺疾病从脾论治理论探讨[J].中国中医药信息杂志,2013,20(12):88-89.
[14]陈公灿,李映霞,周志友,等.补中益气汤联合西医常规疗法治疗稳定期慢性阻塞性肺疾病临床观察[J].上海中医药杂志,2012,46(7):42-44.
[15]张朝宁,李金田.“肺肾相关”理论探讨及现代研究进展[J].新中医,2016,48(1):200-201.
[16]臧皓,张海丰,徐倩,等.蛤蚧的化学成分及药理作用[J].吉林中医药,2016,36(9):919-921.
[17]王国臣.人参蛤蚧散加减对慢性阻塞性肺疾病缓解期患者肺功能及生活质量的影响[J].中医学报,2017,32(2):198-200.
[18]孙慧,齐曼古丽·吾守尔,胡欣,等.哮喘-慢阻肺重叠综合症研究近况[J].临床肺科杂志,2018,23(2):347-351.
[2]孙婉璐,陈亚红.2016版全球哮喘防治创议更新简介[J].中国医学前沿杂志(电子版),2016,8(7):33-40.
[3]廉洁,潘殿柱.哮喘-慢性阻塞性肺病重叠综合征发病机制研究进展[J].辽宁医学院学报,2016,37(5):107-109.
[4]陈石,李磊,吴刚,等.吸入激素联合噻托溴铵治疗哮喘-慢阻肺重叠综合症的临床疗效评价[J].临床肺科杂志,2015,20(10):1856-1860.
[5]LOUIE S,ZEKI AA,SCHIVO M,et al.The asthma-chronic obstructive pulmonary disease overlap syndrome:pharmacotherapeutic considerations.Expert Rev Clin Pharmacol,2013,6(2):197-219.
[6]DIAZ-GUZMAN E,KHOSRAVI M,MANNINO D M.Asthma,chronic obstructive pulmonary disease,and mortality in the U.S.population.COPD,2011,8(6):400-407.
[7]孙永昌.哮喘-慢阻肺重叠综合征指南解读[J].中国呼吸与危重监护杂志,2014,13(4):325-329.
[8]李雯雯,朱雪,郭梦倩,等.论风邪在多种呼吸系统疾病发病机制中的重要作用[J].时珍国医国药,2013,24(11):2738-2739.
[9]王付.小青龙汤方证及变证与衍生方的应用[J].中医杂志,2013,54(22):1908-1910,1925.
[10]戴晓新,洪旭初.慢阻肺-哮喘重叠综合征及药物治疗现状[J].实用医学杂志,2014,30(14):2189-2190.
[11]孙子凯.金陵名医曹世宏治疗肺系疾病经验[J].中华中医药杂志,2017,32(1):190-193.
[12]王丽华,张元兵,兰智慧,等.国医大师洪广祥教授治疗慢性阻塞性肺疾病经验[J].中华中医药杂志,2016,31(7):2590-2592.
[13]吴瑶,王飞,王全林,等.慢性阻塞性肺疾病从脾论治理论探讨[J].中国中医药信息杂志,2013,20(12):88-89.
[14]陈公灿,李映霞,周志友,等.补中益气汤联合西医常规疗法治疗稳定期慢性阻塞性肺疾病临床观察[J].上海中医药杂志,2012,46(7):42-44.
[15]张朝宁,李金田.“肺肾相关”理论探讨及现代研究进展[J].新中医,2016,48(1):200-201.
[16]臧皓,张海丰,徐倩,等.蛤蚧的化学成分及药理作用[J].吉林中医药,2016,36(9):919-921.
[17]王国臣.人参蛤蚧散加减对慢性阻塞性肺疾病缓解期患者肺功能及生活质量的影响[J].中医学报,2017,32(2):198-200.
[18]孙慧,齐曼古丽·吾守尔,胡欣,等.哮喘-慢阻肺重叠综合症研究近况[J].临床肺科杂志,2018,23(2):347-351.