梁直英治疗支气管扩张经验析要  

Experience of LIANG Zhi-Ying in Treating Bronchiectasis

作　　者：张高[1] 杨柳柳[1] 褚庆民[1] 黄楚栓 ZHANG Gao;YANG Liu-Liu;CHU Qing-Min;HUANG Chu-Shuan(The First Affiliated Hospital of Guangzhou University of Chinese Medicine,Guangzhou 510405 Guangdong,China)

机构地区：[1]广州中医药大学第一附属医院,广东广州510405

出　　处：《广州中医药大学学报》2022年第6期1397-1401,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金青年项目(编号:81904132);广东省中医药局基金项目(编号:20212056)

摘　　要：总结梁直英教授运用中医药治疗支气管扩张的临床经验。梁直英教授认为支气管扩张患者的病机特征为本虚标实,本虚为肺脾亏虚,标实与痰、热、瘀及外邪入侵相关,但痰瘀贯穿病程始终。临床需分急性感染期和稳定期辨证施治。急性感染期以清热化痰、凉血泻火为法,可选清肺止血汤或千金苇茎汤加减治疗;稳定期以益气养阴、补虚固本为法,常用苇茎汤合补益肺脾肾的参苓白术散、玉屏风散、四君子汤、补中益气汤、补肺汤、麦味地黄丸、沙参麦冬汤等加减治疗。因支气管扩张具有痰、热、瘀的病症特点,故治疗时需清热化痰而不忘活血化瘀。临证中善用加味千金苇茎汤治疗本病,疗效较显著。This article summarized the clinical experience of Professor LIANG Zhi-Ying for the treatment of bronchiectasis with Chinese medicine.Professor LIANG believes that the pathogenesis of patients with bronchiectasis is characterized by deficiency in the origin and excess in the superficiality.The deficiency is associated with the lung and spleen,while the excess is related to phlegm,heat,blood-stasis and the invasion of external pathogen.And the phlegm and blood-stasis are present throughout the course of the disease.The diagnosis and treatment of bronchiectasis should be based on the identification of acute infection stage and stable stage.In the acute infection stage,the therapy of clearing heat and resolving phlegm,cooling blood and purging pathogenic fire can be adopted,and it is recommended for the use of modified Qingfei Zhixue(clearing lung and stopping bleeding)Decoction or Qianjin Weijing Decoction.In the stable stage,the therapy of replenishing qi and nourishing yin,tonifying deficiency and consolidating vital base can be adopted,and it is recommended for the modified use of Qianjin Weijing Decoction plus the prescriptions of Shenling Baizhu Powder,Yupingfeng Powder,Sijunzi Decoction,Buzhong Yiqi Decoction,Bufei Decoction,Maiwei Dihuang Pills and Shashen Maidong Decoction for tonifying lung,spleen and kidney.For bronchiectasis is usually predominated by the symptoms of of phlegm,heat and blood-stasis,the treatment for clearing heat and resolving phlegm,activating blood and removing blood-stasis should be carried out simultaneously.The application of Qianjin Weijing Decoction in the clinical treatment for bronchiectasis could achieve significant therapeutic effect.

关 键 词：支气管扩张 肺脾亏虚 痰 热 瘀 清热化痰 活血化瘀 梁直英 名医经验 

分 类 号：R259[医药卫生—中西医结合] R249[医药卫生—中医内科学]