基于“火与元气不两立”探析干燥综合征相关间质性肺疾病  

Exploring Interstitial Lung Diseases Related to Sjogren's Syndrome Based on Theory of Contradiction between Fire and Primitive Qi

作　　者：陆家麟 马君[2] LU Jia-lin;MA Jun(Shandong University of Traditional Chinese Medicine,Jinan 250000)

机构地区：[1]山东中医药大学,济南250000 [2]山东中医药大学附属医院,济南250000

出　　处：《河北中医药学报》2023年第3期9-12,17,共5页Journal of Hebei Traditional Chinese Medicine and Pharmacology

基　　金：山东省中医药科技发展计划项目:No.2019-0127;全国名老中医药专家传承工作室资助项目:No.2014。

摘　　要：“火与元气不两立”学说源于《黄帝内经》,医家李东垣对其进一步探析并广泛运用于治疗临床多类疾病。干燥综合征(SS)相关间质性肺疾病(ILD)归属于中医“燥痹”类,一般认为燥热内结为本病病因。阴火为中焦不足、谷精闭滞而生之病火,元气即人体正气之本。在“火与元气不两立”理论指导下认为脾胃虚损,邪火内干是内在病因,元气不足是重要加重因素,阴火猖与元气损之间形成恶性循环。此二者正邪交争,使病情难愈并呈现出症状的多样性,初期病及皮腠清窍,精津不布而干燥少液,进而焦灼肺络,出现干燥综合征相关间质性肺疾病(SS-ILD)各种临床表现。故临证之时应究其根本,主以健运中土,加之宣泄邪火,内外双调,标本兼顾,为SS-ILD的中医治疗提供新的治疗思路。The theory of contradiction between fire and primitive qi originated from Huangdi Neijing(The Yellow Emperor's Inner Classic),and was further explored and widely used by physician Li Dongyuan to treat various clinical diseases.Interstitial lung diseases(ILD)related to Sjogren's syndrome(SS)belongs to the category of zao bi(dryness-induced impediment)in Chinese medicine,and it is generally believed that dryness and heat accumulation are the causes of this disease.Yin fire is a pathogenic fire caused by the deficiency of the middle energizer and the stagnation of grain essence,and the primitive qi is the foundation of the human body's healthy qi.Under the guidance of the theory of contradiction between fire and primitive qi,it is believed that spleen and stomach deficiency and inner dryness of pathogenic fire are the internal causes,and insufficient primitive qi is an important aggravating factor.A vicious cycle is formed between the excessive yin fire and the loss of primitive qi.The conflict between healthy and pathogenic qi causes the disease difficult to heal and presents a variety of symptoms.In the initial stage,the disease involves cutaneous interstices and seven orifices,with no distribution of the essence and fluid but dryness and lack of fluid,which burns the lung meridians and collaterals,leading to various clinical manifestations of interstitial lung disease(SS-ILD)related to Sjogren's syndrome.Therefore,when treating SS-ILD,it is necessary to find the root causes,mainly focusing on invigorating spleen,and in addition,dispersing and purging pathogenic fire.Both internal and external adjustments should be made,and both manifestations and root cause should be taken into account,providing a new treatment approach for SS-ILD in traditional Chinese medicine.

关 键 词：干燥综合征 间质性肺疾病 燥痹 肺痹 肺痿 阴火 元气 脾胃亏虚 

分 类 号：R256.15[医药卫生—中医内科学]