朱慧志治疗支气管扩张症咯血临证经验浅析  

ZHU Huizhi's Experience in the Treatment of Bronchiectasis Hemoptysis

作　　者：李传进 朱慧志[1] LI Chuanjin;ZHU Huizhi(The First Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230031,China)

机构地区：[1]安徽中医药大学第一附属医院,安徽合肥230031

出　　处：《中医药临床杂志》2024年第2期264-267,共4页Clinical Journal of Traditional Chinese Medicine

基　　金：新安绩溪胡氏内科流派工作室建设项目(皖中医药发展秘[2021]30号);安徽省第6批创新领军人才特支计划(T000614)。

摘　　要：支气管扩张症(简称支扩)是以反复咳嗽、大量脓痰为主要临床表现的一种常见的呼吸道疾病,其病情迁延难愈,严重时可伴有咯血,严重影响患者的生活及身心健康。朱师认为,支扩咯血病因主在痰热蕴肺,一则痰热久蕴肺系则伤络灼阴,使肺络伤而又无太阴濡养,络伤血出自不可避免;二则痰热久蕴使肺失制节,动气扰血,气为血之帅,气不安,则血亦难安矣,故血随气出;三则痰热久蕴,久病必瘀为必不可免,加之患者多有反复出血,正所谓离经之血即为瘀血,瘀血与痰热相互胶结,进而导致病情缠绵,反复难愈。朱师本着“塞流”“澄源”“复旧”的原则来加以治疗,根据其病因病机特点以止溢血与清痰热并举,降冲气与逐瘀血共施,辅以养阴复旧以调其根,最后顺其阴阳,调整体质以防患于未然,宗此之法对于支扩咯血的治疗取得良好的疗效。Bronchiectasis is a common respiratory disease with the main clinical manifestations of repeated coughing and large amounts of purulent sputum.The condition is protracted and difficult to cure.In severe cases,it may be accompanied by hemoptysis,which seriously affects the patient’s life and physical and mental health.Master ZHU believes that the main cause of bronchiectasis and hemoptysis is that phlegm heat accumulates in the lungs.First,if phlegm heat accumulates in the lungs for a long time,it will damage the collateral and burn the Yin,causing damage to the lungs and collateral without the nourishment of Taiyin.Blood from the collateral damage is inevitable;secondly,phlegm will damage the lungs.Heat accumulated for a long time will cause the lungs to lose control,and the Qi will disturb the blood.In addition,patients often suffer from repeated bleeding.As the saying goes,blood stasis is called blood stasis.Blood stasis and phlegm-heat are mutually cemented,which leads to lingering illness and repeated difficulty in recovery.Master ZHU treats the patient based on the principles of“stopping flow”,“clearing the source”and“restoring the old”.According to the characteristics of its etiology and pathogenesis,he simultaneously stops bleeding and clears phlegm and heat,lowers Qi and removes blood stasis,supplements it with nourishing Yin and restoring old age.Regulating its roots,and finally following its Yin and Yang,adjusting the body’s constitution to prevent problems before they occur.This method has achieved good results in the treatment of bronchiectasis and hemoptysis.

关 键 词：支气管扩张 支扩咯血 朱慧志 名医经验 

分 类 号：R562.22[医药卫生—呼吸系统]