丁元庆从肺胃失和论治阻塞性睡眠呼吸暂停低通气综合征经验  

DING Yuanqing's Experience in Treating Obstructive Sleep Apnea Hypopnea Syndrome from Disharmony of Lung and Stomach

作　　者：李雪君 于成 李佳静 胡春雨[2] 唐赛雪[2] 丁元庆(指导)[2] LI Xuejun;YU Cheng;LI Jiajing;HU Chunyu;TANG Saixue(The Affiliated Hospital of Shandong University of Traditional Chinese Medicine;Shandong University of Traditional Chinese Medicine)

机构地区：[1]山东中医药大学附属医院,山东省济南250014 [2]山东中医药大学

出　　处：《中医杂志》2023年第11期1090-1094,共5页Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局全国名老中医药专家传承工作室建设项目。

摘　　要：总结丁元庆教授从肺胃失和论治阻塞性睡眠呼吸暂停低通气综合征的临证经验。认为肺胃失和是本病的关键病机,治以调和肺胃、宣畅气机。临证时辨证分型,阳明热盛证宜清热泻火、降气导浊,用小承气汤合泻心汤加减;湿热中阻证宜清热利湿、和胃降逆,用茵陈蒿汤加减;痰瘀互结证宜活血祛瘀、化痰降逆,用桂枝茯苓丸合半夏厚朴汤加减;气虚痰阻证宜补中益气、行水化痰,用防己黄芪汤合厚朴生姜半夏甘草人参汤加减;气阴亏虚证宜益气养阴,用参芪地黄汤加减。同时重视咽喉治疗,常用射干、贝母、醋鳖甲等疏利气血、通利咽喉之品;强调防重于治,尤以改善不良生活方式为要。This paper summarized the clinical experience of Professor DING Yuanqing in the treatment of obstructive sleep apnea hypopnea syndrome(OSAHS)based on the theory of lung and stomach disharmony.It is believed that the disharmony of the lung and stomach is the key pathogenesis of OSASH,and the treatment should be regulating and harmonizing the lung and stomach,diffusing and promoting the flow of qi.The treatment should be performed according to the differentiated syndromes.It is proposed that for exuberant heat of yangming(阳明),the method of clearing heat and draining fire,directing qi downward and removing turbidity should be used with modified Xiaochengqi Decoction and Xiexin Decoction(小承气汤合泻心汤).If there is dampness-heat obstructing the center,it is suggested to clear heat and drain dampness,harmonize the stomach and direct counterflow downward with modified Yinchenhao Decoction(茵陈蒿汤).For binding of phlegm and stasis,it is suggested to activate blood circulation and remove stasis,resolve phlegm and direct counterflow downward,with modification of Guizhi Fuling Pill and Banxia Houpu Decoction(桂枝茯苓丸合半夏厚朴汤).In terms of qi deficiency and phlegm obstruction syndrome,the method of supplementing the center and boosting qi,resolving phlegm and promoting diuresis can be used,and the modified Fangji Huangqi Decoction and Houpu Shengjiang Banxia Gancao Renshen Decoction(防己黄芪汤合厚朴生姜半夏甘草人参汤).For qi yin depletion,it is suggested to boost qi and nourish yin with modified Shenqi Dihuang Decoction(参芪地黄汤).Moreover,importance is attached to throat management by using medicinals with the function of soothing and promoting qi and blood,and unblocking the throat,such as Shegan(Rhizoma Belamcandae),Beimu(Bulbus Fritillariae)and vinegar prepared Biejia(Carapax Trionycis).At the same time,it is emphasized that OSAHS is difficult to be cured but can be prevented,especially a healthy lifestyle is critical.

关 键 词：阻塞性睡眠呼吸暂停低通气综合征 肺胃相关 名医经验 丁元庆 

分 类 号：R249[医药卫生—中医临床基础] R276.1[医药卫生—中医学]