从“火伏阴络”论肺间质纤维化中医病机演变和治则  

Discussion on TCM Pathogenesis Evolution and Treatment Principle of Pulmonary Interstitial Fibrosis from“Fire Subdues Yin Collateral”

作　　者：毕张扬 杨帆[1] 张伟[2] BI Zhangyang;YANG Fan;ZHANG Wei(Shandong University of Traditional Chinese Medicine,Jinan 250014,Shandong,China;Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250011,Shandong,China)

机构地区：[1]山东中医药大学,山东济南250014 [2]山东中医药大学附属医院,山东济南250011

出　　处：《辽宁中医药大学学报》2021年第1期63-66,共4页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：国家自然科学基金(81874442);山东省人民政府“泰山学者”建设工程专项经费资助项目(ts201712096)。

摘　　要：中医理论认为病程日久,无论外感六淫邪气,亦或内生痰瘀湿滞,诸邪久积,皆有郁而化热的倾向。肺间质纤维化是多种肺疾病发展到最后的结局,符合中医病久"郁而化热"的病机特点,临床经验亦表明,肺间质纤维化具有从热转化的特性。热为火之渐,火为热之极,热郁日久可化火,火气内炎亦可生热,热与火密不可分。因此在"阴络"载体下,从气络阳气郁久化火、血络痰瘀蕴而生火角度,结合脾脏与肺系疾病的密切联系,从肺、脾两脏阐述肺间质纤维化气血津液失运导致病理产物蓄积而化热化火的病理过程,并在"火伏阴络"病机指导下,结合中医理论,提出在血"去有形之邪,灭无形之火",在气"降气以降火,升阳以潜火"的治则,以期为临床提供新的借鉴与参考。According to the theory of traditional Chinese medicine,with a long course of disease,no matter the external six evils or the internal phlegm,stasis and dampness,all evils accumulate for a long time,all have the tendency of depression and heat transformation.Pulmonary interstitial fibrosis is the final outcome of a variety of lung diseases,which is in line with the pathogenesis characteristics of"depression and heat".Clinical experience also shows that pulmonary interstitial fibrosis has the characteristics of transforming from heat.Heat is the gradual development of fire,and fire is the extreme of heat.If the heat is depressed for a long time,it can turn into fire.If the fire is inflamed,it can also generate heat.Heat and fire are inseparable.Therefore,under the carrier of"Yin and collaterals",the paper expounds the pathological process of lung interstitial fibrosis,which leads to the accumulation of pathological products and the transformation of heat and fire due to the loss of Qi,blood and body fluid in the lung and spleen.Under the guidance of the pathogenesis of"fire subdues Yin and collaterals"and in combination with the theory of traditional Chinese medicine,it puts forward that"removing the visible evil and eliminating the non visible evil"in blood"fire of form"is the treatment principle of"lowering Qi to reduce fire,rising Yang to submerge fire",in order to provide new reference for clinical practice.

关 键 词：火伏阴络 降气 升阳 少火 

分 类 号：R563[医药卫生—呼吸系统]