基于“皮腠-筋骨-脏腑”探讨结缔组织病相关间质性肺病中医病机演变  

Exploring the evolution of the TCM pathogenesis of connective tissue disease-associated interstitial lung disease based on the“skin-bones-viscera”syndromes

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

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

出　　处：《吉林中医药》2021年第11期1405-1408,共4页Jilin Journal of Chinese Medicine

基　　金：国家自然科学基金(81874442);泰山学者“建设工程专项经费”资助(ts201712096);山东省张伟名老中医药专家传承工作室建设项目。

摘　　要：六淫入侵“皮腠-筋骨-脏腑”,造成机体卫阳不温、营卫滞涩、气血痹阻、痿弱不用为结缔组织病相关间质性肺疾病的基本病机。“五体-五脏”为基本病位。在目前从营卫失和论述结缔组织病,从五脏相关论述间质性肺疾病的基础上,从“五体营卫滞涩-五脏气血痹阻-体脏失荣枯损”的环形气血传变系统论治结缔组织病相关间质性肺疾病。外邪入侵五体,皮腠-筋骨邪气内传相连之脏,脏腑痹阻痿弱后续难以濡养五体,且心、肝、脾、肾四脏皆可累及肺脏。治疗上,先补卫阳以安未受邪之地,再祛实邪截疾病发展途径,后补体脏改善机体预后,整体改善体脏气血痹阻痿弱之变。The invasion of the six climatic exopathogens into the“skin-bones-viscera”,resulting in the low-temperatured defensive yang,stagnant nutrient qi and defensive qi,qi and blood obstruction,and impotence in the body,constitutes the basic pathogenesis of connective tissue disease-associated interstitial lung disease,while the five body constituents and five zang viscera are the basic disease locations.Based on the current discussion of connective tissue disease from the disharmony between nutrient qi and defensive qi,and the discussion of interstitial lung disease from the fi ve zang association,this paper systematically discusses the treatment of connective tissue disease-associated interstitial lung disease from the circular qi-blood transmission of“stagnant nutrient qi and defensive qi in the fi ve body constituents-qi and blood obstruction in the fi ve zang viscera-decline and impotence of the body”.External pathogens fi rst invade the fi ve body constituents,then the pathogenic qi in the skin and bones transmits inward into the connected internal organs,consequently the blocked and withered viscera fail to moisten and nurture the fi ve body constituents.Additionally,the heart,liver,spleen and kidney can all encumber the lungs.As for its treatment,the fi rst step is to invigorate the defensive yang to protect the unaffected areas,and then eliminate the excessive pathogens and cut off the disease development,and last to tonify the viscera to improve the body’s prognosis,improving the overall transmission of qi-blood stagnation and obstruction in the constituents and viscera,and the transmission of impotence and fatigue in the body.

关 键 词：结缔组织病 皮肉脉筋骨 间质性肺疾病 营卫失合 温补卫阳 五脏相关 

分 类 号：R2-031[医药卫生—中西医结合]