何若苹从益气养阴法辨治肺癌咳嗽经验探析  

Analysis of HE Ruoping's Experience in Syndrome Differentiation and Treatment of Lung Cancer-induced Cough by Replenishing Qi and Nourishing

作　　者：俞蒙洁 赵洁 徐艳琳 何若苹[2] Yin YU Mengjie;ZHAO Jie;XU Yanlin(The Third Clinical Medical School of Zhejiang Chinese Medical University,Hangzhou(310053),China)

机构地区：[1]浙江中医药大学第三临床医学,院杭州310053 [2]浙江中医药大学附属第三医院

出　　处：《浙江中医药大学学报》2023年第4期370-374,共5页Journal of Zhejiang Chinese Medical University

摘　　要：[目的]探讨何若苹教授运用益气养阴法辨治肺癌咳嗽的临床经验。[方法]通过临证学习,总结何师对肺癌咳嗽病因病机的认识及辨证论治,阐述何师治疗该病的临床经验,并附验案一则。[结果]何师认为,肺癌咳嗽病性属本虚标实,以气阴亏虚为本,风邪、气滞、血瘀、痰浊、热毒为标,并根据临床症状将其分为气阴亏虚、外邪袭肺、痰热壅肺、气滞血瘀、脾肾两虚5个证型,分别治以扶正祛邪、益气养阴,急则治标、祛邪止咳,清肺解毒、化痰止咳,理气疏肝、化瘀止咳和培土生金、补肾纳气,以参芪苓蛇汤、止嗽散、清金化痰汤等方加减治疗,效如桴鼓。在本例医案中,何师针对癌毒留积、痰浊阻肺证,运用益气养阴法,诸药相合,使热除痰消气顺,咳嗽自愈。[结论]何师治疗肺癌咳嗽以益气养阴为根本大法,详审病机,准确辨证,灵活遣方用药,临床疗效确切,其经验值得学习推广。[Objective]To explore Professor HE Ruoping's clinical experience in treating lung cancer-induced cough by replenishing Qi and nourishing Yin.[Methods]Through clinical study,summarizing Professor HE's understanding of the etiology and pathogenesis of lung cancer-induced cough and syndrome differentiation and treatment,this paper expounded Professor HE's clinical experience in the treatment of this disease,and a case was included.[Results]According to Professor HE,the lung cancer-induced cough is inseparable from lung cancer itself.The nature of this disease belongs to asthenia in origin and asthenia in superficiality,with deficiency of Qi and Yin as the origin,and wind pathogen,Qi depression,blood stasis,phlegm turbidity and heat toxin as the superficiality.Based on its clinical symptoms,it can be divided into five types of syndrome,including deficiency of Qi and Yin,exogenous evils attacking the lung,phlegm-heat obstructing the lung,Qi stagnation and blood stasis and deficiency of both the spleen and kidney,which are respectively treated with strengthening body resistance and eliminating evil,tonifying Qi and nourishing Yin;treating the symptoms in case of urgency,removing pathogens and relieving cough;clearing the lung and detoxifying,resolving phlegm and relieving cough;dredging the liver and regulating Qi,removing blood stasis and relieving cough;reinforcing earth to generate metal and tonifying the kidney and holding Qi.If Shenqi Lingshe Decoction,Zhisou Powder,Qingjin Huatan Decoction and other prescriptions are adopted for modified treatment,this disease will receive an instant treatment effect.In the medical case,Professor HE applied the method of replenishing Qi and nourishing Yin to the patient's syndrome of cancer toxin retention and phlegm obstructing the lung,so that the patient could get rid of phlegm with heat,eliminate Qi,and recover from cough.[Conclusion]Professor HE takes replenishing Qi and nourishing Yin as the fundamental method for treating lung cancer-induced cough,scrutinizes the pathogene

关 键 词：肺癌咳嗽 益气养阴 辨证论治 验案 名医经验 何若苹 

分 类 号：R273[医药卫生—中西医结合]