基于平脉辨证诊治弥漫性实质性肺疾病验案两则  

Two Proved Cases of Treatment of Diffuse Parenchymal Lung Disease Based on Differentiating Syndrome by Pulse Diagnosis

作　　者：吴聪 罗成 王玉光[1] WU Cong;LUO Cheng;WANG Yuguang(Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University,Beijing 100010,China;Beijing University of Chinese Medicine,Beijing 100029,China;Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京中医医院,北京100010 [2]北京中医药大学,北京100029 [3]首都医科大学,北京100069

出　　处：《山东中医杂志》2023年第3期295-298,共4页Shandong Journal of Traditional Chinese Medicine

基　　金：首都卫生发展科研专项(编号:首发2020-2-2233)。

摘　　要：弥漫性实质性肺疾病包含200多种异质性疾病,本病患者因肺结构破坏导致换气功能障碍,从而出现呼吸衰竭,预后较差,临床对本病缺乏有效治疗手段。平脉辨证强调以脉解症释舌,从平脉辨证角度论治弥漫性实质性肺疾病,以脉定病位、病性、病势,据脉诊治,可供临床参考。列举相关验案两则,案1患者双寸脉细弱,提示心肺阳损、宗气下陷,方用张锡纯回阳升陷汤加减而症状皆减;案2患者寸关脉弦滑、双尺脉沉弱,辨证为肺肾不足、阴阳俱虚,治以补益肺肾、纳气平喘,咳嗽减轻。Diffuse parenchymal lung disease contains more than 200 heterogeneous diseases.Patients with this disease have poor prognosis because the lung structure destruction leads to ventilation dysfunction and thus causes respiratory failure.At present,there is no effective treatment for this disease.Differentiating syndrome by pulse diagnosis emphasizing the importance of analyzing symptoms and tongue according to pulse.In the treatment of diffuse parenchymal lung disease from the perspective of differentiating syndrome by pulse diagnosis,the position,property,and condition of the disease is determined according to the pulse,and the diagnosis and treatment were based on the pulse,which can provide reference for clinical practice.There are two proved cases listed in this article.In case 1,the bilateral cun pulse of the patient was thin and weak,indicating yang impairment in heart and lung,and sinking of pectoral qi.The Huiyang Shengxian Decoction(回阳升陷汤)created by ZHANG Xichun was modified for this patient and his symptoms were relieved after taking it.In case 2,the patient’s cun pulse and guan pulse were slippery and wiry,and the bilateral chi pulse was deep and weak,indicating the insufficiency of the lung and the kidney,and the deficiency of both yin and yang.Accordingly,the treatment is to benefit the lung and the kidney,improve qi reception,and relieve dyspnea,which relieve the cough finally.

关 键 词：弥漫性实质性肺疾病 平脉辨证 以脉解症 脉症相参 医案 李士懋 

分 类 号：R249[医药卫生—中医临床基础] R256.13[医药卫生—中医学]