基于宗气、元气理论探讨慢性阻塞性肺疾病的病机与辨治  

Discussion on the Pathogenesis,Differentiation and Treatment of Chronic Obstructive Pulmonary Disease based on the Pectoral Qi and Original Qi Theory

作　　者：吴蕾[1] 郑俐慈 陈远彬[1] 林琳[1] WU Lei;ZHENG Lici;CHEN Yuanbin;LIN Lin(The Second Clinical Medical College of Guangzhou University of Chinese Medicine/Guangdong Province Traditional Chinese Medical Hospital,Guangzhou,510120)

机构地区：[1]广州中医药大学第二临床医学院/广东省中医院,广东广州510120

出　　处：《中医杂志》2023年第14期1440-1443,共4页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82074343);广东省中医院中医药科学技术研究专项(YN2022MS13);广东省中医院中医药科学技术研究专项(YN2019ML03);中华中医药学会青年求实项目(2022-QNQSDEP-04);广东省中医院名中医药专家学术经验传承工作室建设项目(中医二院[2014]89号)。

摘　　要：基于宗气、元气理论探讨慢性阻塞性肺疾病(简称慢阻肺)的病机与辨治,为临床诊治提供思路。认为慢阻肺的主要病机为肺脾气虚,致宗气虚衰,久病咳喘,日久累及于肾,耗损元气;同时因肺脾肾失司,津液输布失常,酿生痰、湿、瘀,阻碍元气的敷布和充养,元气不足加之布散无力可加重肺虚,进而咳喘加重,如此恶性循环,缠绵难愈。提出慢阻肺的治疗重在培扶宗元之气,可使五脏功能健旺,以终止正虚致邪实、邪实促正虚的恶性循环。宗元之气旺盛,脏腑功能健运,呼吸得司则宣肃得宜,津液得运,气机得畅,则痰、湿、瘀得化而散。培扶宗元的治法主要包括养元、布元、活元,即补益后天以养先天之气、宗气升转以输布元气、温阳益精以激活元气。This paper discussed the the pathogenesis,differentiation and treatment of chronic obstructive pulmo-nary disease(COPD)based on pectoral qi and original qi theory,so as to provide reference for clinical diagnosis and treatment.It is believed that the main pathogenesis of COPD is lung and spleen qi deficiency resulting in pectoral qi depletion,and chronic cough and asthma,with the kidneys damaged over time,and thereafter consuming original qi;si-multaneously,due to the dysfunction of lung,spleen and kidney.There is disordered transportation of the body fluid,and the phlegm,dampness and stasis are generated,obstructing the distribution and nourishment of original qi;insuf-ficient original qi and weak dispersion aggravate the lung deficiency,and thereby increasing the severity of cough and asthma.With such a vicious cycle,the disease is lingering and difficult to be cured.It is proposed that the treatment of COPD should focus on banking up and reinforcing pectoral and original qi,which can promote the well-functioning of the five zang organs,and end the vicious cycle that healthy qi deficiency leading to pathogen excess,and pathogen excess promoting healthy qi deficiency.When the pectoral qi is vigorous,the zang fu organs well function in transpor-tation,and the breathing is properly controlled,there will be appropriate diffusion and purification,and the body fluid is transported,and the qi movement is smooth,and finally the phlegm,dampness and stasis are dissolved and dis-persed.The method of banking up and reinforcing pectoral and original qi mainly includes nourishing,dispersing and activating original qi,which means supplementing the acquired qi to nourish the congenital qi,raising and transforming the pectoral qi to transport and disperse the original qi,warming yang and boosting essence to activate the original qi.

关 键 词：慢性阻塞性肺疾病 宗气 元气 

分 类 号：R259[医药卫生—中西医结合]