基于“玄府-肺络”理论论治结缔组织病相关间质性肺病  

Treatment of Connective Tissue Disease Associated Interstitial Lung Disease from Perspective of"Xuanfu-Lung collaterals"Theory

作　　者：王源 黄东晖[2] WANG Yuan;HUANG Donghui(Guangzhou University of Chinese Medicine,Guangzhou Guangdong China 510006;Zhuhai Branch of Guangdong Provincial Hospital of Traditional Chinese Medicine,Zhuhai Guangdong China 519015)

机构地区：[1]广州中医药大学,广东广州510006 [2]广东省中医院珠海医院,广东珠海519015

出　　处：《中医学报》2022年第7期1384-1389,共6页Acta Chinese Medicine

基　　金：广东省教育厅自然科学基金项目(2020KZDZX-1053)。

摘　　要：结缔组织病相关间质性肺病(connective tissue disease associated interstitial lung disease,CTD-ILD)是结缔组织病(connective tissue disease,CTD)临床常见并发症之一,是引起CTD患者死亡的重要原因。肺微循环病变是CTD-ILD最主要病理特点,是肺纤维化、肺血管重塑及继发性肺动脉高压等的危险因素。肺微循环作为肺部最小的功能单位,与中医“玄府-肺络”有相对应的生理病理基础。CTD-ILD各期气郁、痰阻、血瘀、神失的病机与“玄府-肺络”构效异常密切相关。临证治疗顺应“玄府-肺络”贵于通利的特性,立足于“开玄通络”治则,不离辛药,重视通补,对CTD-ILD各阶段进行分期论治,初期以“宣肺开玄、畅通气机”为主,中期以“化痰祛瘀、搜风通络”为宜,末期以“扶正固本、转复神机”为要。Connective tissue disease associated interstitial lung disease(CTD-ILD)is one of the common clinical complications of connective tissue disease(CTD)and an important cause of death in patients with CTD.Western medicine treatment has certain limitations.Pulmonary microcirculation lesions are the most important pathological features of CTD-ILD,and are risk factors for pulmonary fibrosis,pulmonary vascular remodeling,and secondary pulmonary hypertension.As the smallest functional unit of the lung,the pulmonary microcirculation has a corresponding physiological and pathological basis with the"Xuanfu-Lung collaterals"of traditional Chinese medicine.The pathogenesis of Qi stagnation,phlegm obstruction,blood stasis,and loss of mind in each stage of CTD-ILD is closely related to the abnormal structure and effect of"Xuanfu-Lung collaterals".The clinical treatment conforms to the characteristic that unobstructed"Xuanfu-Lung collaterals"is the most important thing and the treatment principle should be"Opening the Xuanfu and dredging the collaterals"and the drugs with pungent flavor should be applied in clinics.In first stage of treatment,"diffusing the Lung Qi,opening the Xuanfu as well as regulating the Qi movenent"should be carried out;in the middle stage off treatment,"resolving Phlegm and blood stasis as well as dispelling for Wind and dredging collaterals"is the appropriate method;in the end,"reinforcing the Zheng Qi to strengthen the body as well as restoring the spiritual state"is the main point.

关 键 词：结缔组织病 间质性肺病 肺微循环 玄府-肺络理论 开玄通络 

分 类 号：R256.1[医药卫生—中医内科学]