芪冬活血饮加减治疗肺间质纤维化的临证经验  

Clinical Experience of Treating Pulmonary Interstitial Fibrosis with Qidong Huoxue Decoction

作　　者：徐俪颖[1] 蔡宛如 王会仍[1] 赵玮[1] XU Liying;CAI Wanru;WANG Huireng(The First Affiliated Hospital of Zhejiang Chinese Medical University,Hangzhou(310006),China;The Second Affiliated Hospital cf Zhejiang Chinese Medical University)

机构地区：[1]浙江中医药大学附属第一医院,杭州310006 [2]浙江中医药大学附属第二医院

出　　处：《浙江中医药大学学报》2022年第2期148-151,共4页Journal of Zhejiang Chinese Medical University

基　　金：浙江省中医药科技计划科研基金项目(2020ZB067、2021ZQ031);浙江中医药大学自然科学青年探索项目(2021JKZKTS048B)。

摘　　要：[目的]总结第二批全国老中医药专家学术经验继承工作指导老师王会仍教授治疗肺间质纤维化(pulmonary interstitial fibrosis,PIF)的学术思想和临床经验,力求继承发扬。[方法]通过跟师侍诊,整理典型医案,梳理王会仍教授对PIF病因病机的认识,阐述其临证心法,总结经验方芪冬活血饮的组成、方义及效用,并举验案以证明之。[结果]PIF的病因病机有气阴两虚、热毒熏蒸、痰瘀互阻。王会仍教授治疗PIF,主抓"虚、热、瘀"的病理基础,临证遵循清热解毒、袪瘀通腑、益气养阴为主的治疗原则,强调气阴同治、肺肠同治、气血同治,常用自拟"芪冬活血饮"加减治疗。文中所举闭塞性细支气管炎伴机化性肺炎验案为气阴不足、痰瘀交阻之肺痿,以芪冬活血饮加减,益气养阴化瘀、化痰通络平喘,疗效显著。[结论]王会仍教授运用芪冬活血饮治疗PIF,以达益气养阴、清肺化痰、祛瘀通腑之效,其学术思想和临证经验值得学习传承。[Objective]To summarize,inherit and develop the clinical experience of Professor WANG Huireng,one of the second group of national TCM experts of academic experience inheritance and instruction,in the treatment of pulmonary interstitial fibrosis(PIF).[Methods]Through consulting with Professor WANG Huireng and collating the typical medical cases,this paper summarized Professor WANG Huireng’s understanding of the etiology and pathogenesis of PIF,elaborated the clinical methods,summarized the composition,formula and effect of the empirical formula Qidong Huoxue Decoction,and verified it through a typical medical case.[Results]The etiology and pathogenesis of PIF are deficiency of both Qi and Yin,heat-toxin fumigating,phlegm obstruction and blood stagnation.Professor WANG Huireng focuses on the pathologic basis of“deficiency,heat,stasis”,follows the treatment principle of clearing away heat and detoxifying,removing blood stasis and purging viscera,supplementing Qi and nourishing Yin,emphasizes on treating Qi and Yin together,treating the lung and bowel together,treating Qi and blood together,and formulates Qidong Huoxue Decoction,which has achieved good clinical effect.The case was bronchiolitis obhterans with organizing pneumonia which belonged to the lung atrophy of deficiency of Qi and Yin,phlegm obstruction and blood stasis.Professor WANG prescribed with modified Qidong Huoxue Decoction to replenish Qi and nourish Yin,eliminate phlegm and resolve stasis,as well as dredge the collateral and relieve asthma,which got significant effect.[Conclusion]Professor WANG Huireng uses Qidong Huoxue Decoction to treat PIF in order to replenish Qi and nourish Yin,clear lung and eliminate phlegm,resolve stasis and dredge the viscera.His academic thought and clinical experience are worth learning and inheriting.

关 键 词：芪冬活血饮 肺间质纤维化 中医治疗 名老中医 学术传承 王会仍 

分 类 号：R273[医药卫生—中西医结合]