从肾虚论治肺间质纤维化  

Treatment of Pulmonary Interstitial Fibrosis from Perspective of Kidney Deficiency

作　　者：蔡治国[1] 刘晓明[1] CAI Zhiguo;LIU Xiaoming(The Affiliated Hospital to Shandong University of Traditional Chinese Medicine,Jinan Shandong China 250011)

机构地区：[1]山东中医药大学附属医院,山东济南250011

出　　处：《中医学报》2018年第5期733-735,共3页Acta Chinese Medicine

基　　金：山东省中医药科技发展计划项目(2015-087)

摘　　要：肺间质纤维化极易伤肾而致肾虚,且治疗过程极易出现伤肾的情况,进而加重肾虚。而肾虚导致肺气不能敛降,宣降失常,壅滞于胸;气滞则血瘀,气滞则痰聚,进一步加重气滞。同时,肾虚可致卫气不固,极易受到外邪侵袭,从而进一步损伤肺气,加重肺间质纤维化。故从肾虚论治肺间质纤维化的治疗方法主要有:(1)补肾纳气法:宜在补益肺气的同时,加用补肾纳气的中药如鹿茸、海龙、海马、蛤蚧、熟地黄、胡桃肉、补骨脂、山萸肉、龙骨、牡蛎、磁石、五味子等,如出现潮热、盗汗、舌红少苔等阴虚之象时,治以补肾养阴、纳气定喘,方以七味都气丸加减,药以熟地黄、山萸肉、干山药(微焙)、牡丹皮、白茯苓、泽泻、五味子、女贞子、枸杞子、天冬为主;(2)补肾化痰法:在止咳化痰药中配伍滋补肾精之品,如淫羊藿、菟丝子、山萸肉、熟附子、紫河车等以温肾化痰,能显著减轻患者咳喘、气促等症状;(3)补肾活血法:选用红花、川芎、丹参、当归、地龙以活血,同时配伍熟地黄、山萸肉、女贞子等以补肾之阴精。Pulmonary interstitial fibrosis can easily cause Kidney deficiency and lead to renal fibrosis,and the treatment process also can easily cause Kidney injury,which in turn aggravates Kidney deficiency. The deficiency of Kidney can cause the Lung Qi to be unable to converge and descend,thus leading to Lung Qi declare abnormally and stagnating on the chest. Qi stagnation causes Blood stasis and stagnation of Phlegm,which in turn further increases qi stagnation. At the same time,the deficiency of Kidney can cause Wei Qi deficiency and being vulnerable to the attack of exogenous pathogens,which would further damages Lung air and aggravates pulmonary fibrosis. Therefore,the treatment of pulmonary interstitial fibrosis in perspective of Kidney deficiency mainly includes：（1）Kidney-nourishing and Qi strengthening method： It is recommended to supplement the kidneys with Chinese medicine such as Pilose antler,Sea dragon,Hippocampus,Gecko,Rehmannia,Walnut meat,Psoralen,Hawthorn meat,Keel,Oyster,Magnet,and Schisandra,etc. In case of yin deficiency such as regular fever,night sweats,red tongue,etc.,the rule is to nourish Kidney and nourish Yin in order to dispel asthma by using modified Qiwei Duqi Pill and drugs like Rehmannia,Hawthorn meat,Dry yam(micro-baking）,moutan,White peony,Alisma,Schisandra,Ligustrum lucidum,Gardenia,and asparagine are frequently used.（2）Nourishing Kidney and resolving Phlegm method： in medication of cough and phlegm the drugs of nourishing kidney essence,such as Epimedium,Dodder seed,Hawthorn meat,Cooked aconite,Placenta to warm Kidney and resolve Phlegm,which can significantly reduce the patient’s symptoms such as cough,shortness of breath.（3）Nourishing Kidney and activating Blood circulation method：drug like Safflower,Chuanxiong,Salvia,Angelica,Earthworm are usually used with Rehmannia,Hawthorn meat,Ligustrum lucidum and other drugs which can supplementary Kidney essence.

关 键 词：肾虚 肺间质纤维化 补肾纳气法 补肾化痰法 补肾活血法 

分 类 号：R259.631.3[医药卫生—中西医结合]