从“养胃阴”论治干燥综合征相关性间质性肺疾病  

Treatment of Interstitial Lung Disease Associated with Sjögren’s Disease Based on“Nourishing Stomach Yin”

作　　者：苏健 刘学 张伟[2] 杨诗媛 SU Jian;LIU Xue;ZHANG Wei;YANG Shiyuan(College of Traditional Chinese Medicine,Shandong University of Traditional Chinese Medicine,Jinan 250355,China;The Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Jinan 250011,China)

机构地区：[1]山东中医药大学中医学院,山东济南250355 [2]山东中医药大学附属医院,山东济南250011

出　　处：《山东中医杂志》2024年第4期343-347,356,共6页Shandong Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81874442);“泰山学者”建设工程专项经费资助项目(编号:ts201712096);山东肺系病热毒流派传承工作室建设项目(批文号:鲁卫函〔2021〕45号)。

摘　　要：干燥综合征相关性间质性肺疾病以口咽干燥、腮腺肿大、关节疼痛、进行性呼吸困难等为主要临床表现。脾胃为气机升降之枢纽,为本病病机演变中的核心脏腑。然脾胃升降喜恶各有不同,在温补脾气的同时,亦要强调顾护胃阴的重要性。胃阴与本病的相关性表现在:肺胃经络相同,气机同降,喜恶相似,同气相求,故干燥综合征常累及至肺;胃主通降,胃阴亏损,胃气不降大肠失濡而易见便秘;起初多为肺胃津伤,病久多累及肾液,且因女子经带胎产等生理特点易耗伤津血,故多发于绝经前后妇女;胃阴衰则阳明经无以滋养筋骨关节而见关节屈伸不利。根据胃阴耗伤程度及分期特点,早期甘凉濡润,中期甘寒滋养,晚期滋肾增液。The major clinical manifestations of interstitial lung disease(ILD)associated with Sjögren’s Disease(SjD)(SjD-ILD)are dry throat,parotid gland swelling,joint pain,progressive dyspnea as.Spleen and stomach are the core organs for the evolution of the disease mechanism.However,spleen and stomach are different in the ascending and descending,favor and disfavor.While warming and tonifying spleen,we should also emphasize the importance of taking care of the stomach yin.The correlation between stomach yin and SjD-ILD is shown as follows:lung and stomach are similar in the meridians and collaterals,shares the same qi movement,have the same favor and disfavor,and are the same in the property,so that SjD often involves the lung;stomach dominates the descending,and therefore when the stomach yin is deficient and stomach qi could not descend,there is no moisture in the large intestine usually manifesting as constipation;at first,lung and stomach are usually injured on fluids,and kidney fluid is often involved after a long time,and the body fluid and blood are easily consumed due to the physiological characteristics of women with fetal birth,so it mostly occurs in women before and after menopause;in the case of stomach yin failure,yangming meridian cannot nourish the muscles and joints manifesting as inhibited bending and stretching.According to the degree of stomach yin damage and the characteristic in each stage,sweet and cool medicinals for moistening should be applied in the early stage,sweet and cold medicinals for nourishing should be applied in the middle stage,and medicinals for nourishing kidney and supplementing fluid should be applied in the late stage.

关 键 词：干燥综合征 脾胃分治 养胃阴 间质性肺疾病 叶天士 

分 类 号：R256.1[医药卫生—中医内科学] R593.2[医药卫生—中医学]