慢性支气管炎肺气肿辨治验案一则  

Chinese Medicine Treatment of Chronic Bronchitis and Emphysema

作　　者：葛伟韬 刘珍珠[2] 高云[1] 

机构地区：[1]中国中医科学院望京医院,北京100102 [2]中国中医科学院中医临床基础医学研究所,北京100102

出　　处：《实用中医内科杂志》2017年第2期62-64,共3页Journal of Practical Traditional Chinese Internal Medicine

基　　金：中国中医科学院基本科研业务费自主选题项目--"十二五"重点领域研究专项(ZZ0808006)~~

摘　　要：慢性支气管炎肺气肿为胸中有壅塞之气聚而为实,有内伤、外感两大主因,外感治肺,内伤治肾。多属正虚邪实,虚实夹杂,宜扶正补虚、益气温阳、疏肺散寒、祛邪止咳;"痰挟瘀血碍气,宜养血以流动乎气,降火以清利其痰,用四物汤化裁;寒郁于肺,用麻黄越婢加半夏汤;水停不下,肺气不降,水入即吐,以四苓散化裁;肾虚水枯,肺金不降,以六味丸加减"。初诊当治急标,从疾病本质入手,针对个体病情,除气实,泄其气当选用,然泻气气必乱行,引气下行则当入选,气行于脉道,脉道通畅往往依靠活血化瘀,可选葶苈子泄其气,瓜蒌引气下行,丹参通其血道,加血肉之品水蛭,平喘利尿,降气逆、平肝火、通血脉、利小便使邪有出路,伍杭菊花清肝降火而止泪,综合配伍,症状迅速改善。善于全局把握,急性期缓解后,当从病性本虚入手,化入镇肝熄风汤,气顺再化入补肺体本脏之药,控制疾病。临症当灵活机变、全面审查、辨证用方、随证加减,切不可头痛医头,脚痛医脚,拘泥固执。患者疾病在身,多有担忧、焦虑之情,医者当及时与患者沟通,告知病情和治疗方案,建立充分的相互信任,减消患者顾虑,使其更好的配合治疗。Chronic bronchitis and emphysema for chest congestion and real gas accumulation. There are two major causes of internal injuries and exogenous, and exogenous treat lung while Internal injuries cure kidney. It is always vital Qi deficiency while pathogenic Qi prevailing and deficiency-excess complication. It should be support healthy energy and enriching consumptive disease, invigorating Qi and warming yang, hydrophobic lung cold, and remove pathogens and relieve cough. ＂Phlegm carry stasis due gas, should be raised blood to flow between gas, drop fire to clear lee its phlegm, with four real soup of CD; cold Yu Yu lung, with ephedra more manservant added banxia soup; water stopped down, Lung gas not drop, water into that spit, to four Ling bulk of CD; kidney virtual water dry, lung gold not drop, to six taste pills added reduction＂. Newly diagnosed Dang rule urgent standard, from disease nature starts with, for individual illness, except gas real, relief its gas elected with, so epsom gas gas will mess line, introduction gas down is Dang selected, gas line Yu pulse road, pulse road unobstructed often relies on huoxue of stasis, can selected Cliff Semen Lepidii SEU Descurainiae child relief its gas, melon Lou introduction gas down, salvia pass its blood road, added flesh-and-blood of products leech, flat breath diuretic, drop gas inverse, and flat suffered, and pass blood, and lee pee makes evil has way, WU Hang chrysanthemum clear liver drop fire and check tears, integrated compatibility, symptoms quickly improved. At the global grasp, after acute stage of remission, when starting from the disease of deficiency, in zhengan Xifeng Tang, go into the lungs of the dirty drug, disease control. While flexible variable, comprehensive review, differentiation, with certificate plus and minus, must not stop-gap, particular about stubborn. Patients with disease in the body have many feelings of concerns and anxiety. Doctors should communicate with patients in a timely manner, and told the illness and treatment programmes

关 键 词：慢性支气管炎 肺气肿 内伤 外感 正虚邪实 虚实夹杂 辨证论治 

分 类 号：R259.622.1[医药卫生—中西医结合]