基于“内伤脾胃,百病由生”辨治特发性肺间质纤维化  

Treatment of Idiopathic Pulmonary Interstitial Fibrosis Based on“Internal Injury of Spleen and Stomach Causing Various Diseases”

作　　者：王雅芸 田梅[2] 王灿 张伟[2] WANG Yayun;TIAN Mei;WANG Can;ZHANG Wei(The First Clinical Medical College,Shandong University of Traditional Chinese Medicine,Jinan 250355,China;The Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250014,China)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250355 [2]山东中医药大学附属医院,山东济南250014

出　　处：《山东中医杂志》2022年第9期930-933,共4页Shandong Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81874442);“泰山学者”建设工程专项(编号:ts201712096)。

摘　　要：“内伤脾胃,百病由生”出自李杲《脾胃论》,脾胃为元气生发之本,很多疾病的病机多为脾胃虚弱,升降失司,治疗上应重视脾胃,培补元气。特发性肺间质纤维化虽病机繁复,但究其本质均为“肺气虚损,脾胃不足”。肺正常生理功能的发挥有赖于脾胃运化,胃气不充,元气不足,则不能将水谷之清气上输于肺,故肺虚气少;胃阴液亏损,虚火上炎,则阴虚肺燥;肺脾气虚,气血津液运化失常,停聚于内,变为痰湿、瘀血,最终形成特发性肺间质纤维化。无论是在生理还是病理上,肺与脾胃均密切相关,补益脾胃贯穿特发性肺间质纤维化治疗的全过程。“Internal injury of spleen and stomach causing various diseases”is from LI Gao’s Treatise on Spleen and Stomach.Spleen and stomach is the root for generating original qi,and mechanism of many diseases usually involves deficiency of spleen and stomach,disorders of ascending and descending.Therefore,in treatment spleen and stomach should be emphasized to tonify original qi.Although the disease mechanism of idiopathic pulmonary interstitial fibrosis is complicated,the essence is“deficiency of lung qi and insufficiency of spleen and stomach”.The normal physiological functions of lung depends on the transportation and transformation of spleen and stomach.Deficiency of stomach qi leads to deficiency of original qi,and the clear qi of water and grain failing to reach the lung,resulting as lung qi deficiency;deficiency of yin fluids in stomach leads to uprising of deficient fire,and finally yin deficiency and lung dryness;qi deficiency of lung and spleen leads to transportation and transformation disorder and accumulation of qi,blood and body fluids,resulting into phlegm dampness and blood stasis.Finally,idiopathic pulmonary interstitial fibrosis occurs.Both physiologically and pathologically,lung and spleen and stomach are closely related,and therefore tonifying spleen and stomach should be applied in the whole process ofidiopathic pulmonary interstitial fibrosis treatment.

关 键 词：特发性肺间质纤维化 内伤脾胃 肺脾气虚 痰瘀阻络 健脾益肺 

分 类 号：R256.15[医药卫生—中医内科学]