基于“六郁”理论探析肺结节的病机与辨治  

Analysis of the Pathogenesis and Treatment of Pulmonary Nodules based on the“Six Constraints”Theory

作　　者：姜河延 曹芳 韦婉 程钰 寇梦佳 焦扬 JIANG Heyan;CAO Fang;WEI Wan;CHENG Yu;KOU Mengjia;JIAO Yang(Beijing University of Chinese Medicine,Beijing,100029;Dongfang Hospital,Beijing University of Chinese Medicine)

机构地区：[1]北京中医药大学,北京市100029 [2]北京中医药大学东方医院

出　　处：《中医杂志》2023年第22期2368-2371,共4页Journal of Traditional Chinese Medicine

基　　金：北京市自然科学基金(7202118)。

摘　　要：基于朱震亨“六郁”理论,提出肺结节的形成与气郁、血郁、痰郁、火郁、湿郁、食郁六郁密切相关。认为六郁皆可导致肺结节,其中以气郁为主导,气郁久则化为火郁,导致脾失运化可成痰郁、湿郁、食郁,气不行血则成血郁,六郁相因为病且病机之间相互关联,共同促进肺结节的发生发展。治疗以畅通气机为主,以治疗六郁的经典名方越鞠丸为基本方,并根据六郁偏颇在越鞠丸基础上灵活配伍疏肝理气、清热散结、化痰散结、健脾化湿、消食化积、活血化瘀之品。Based on ZHU Zhenheng's“six constraints”theory,it is proposed that the formation of pulmonary nodules is closely related to the six constraints,which are constraint of qi,blood,phlegm,fire,dampness and food.All six constraints might lead to pulmonary nodules,among which qi constraint is the dominant one.When qi con?straint lasts for a long time,it will turn into fire constraint,resulting in the failure of spleen to transport,which may lead to phlegm constraint,dampness constraint and food constraint;when qi fails to move blood,blood constraint is formu?lated.Mutual generation of six constraints lead to the disease,and the pathogenesis is interrelated,jointly promot?ing the occurrence and development of pulmonary nodules.The treatment is mainly to unblock qi,usually using Yueju Pills(越鞠丸),a classic formula commonly used for six constraints,as the basic formula.And according to the six constraints partiality,it is suggested to flexibly add the medicinals of soothing the liver and rectifying qi,clearing heat and dissipating masses,dissolving phlegm and dissipating masses,fortifying spleen and dissipating dampness,pro?moting digestion and removing accumulation,invigorating blood and dissolving stasis.

关 键 词：肺结节 气郁 火郁 血郁 痰郁 湿郁 食郁 越鞠丸 

分 类 号：R259[医药卫生—中西医结合]