基于叶天士卫气营血理论辨治研究支气管扩张症  

Research on the Diagnosis and Treatment of Bronchiectasia Based on YE Tianshi's Theory of Wei Qi Ying Xue

作　　者：陈晶晶 张念志[2] 薛晓明[1] 韩明向[2] 关炜[1] 尚芳[1] 周波波[1] 孟丽红 张彦博 王娇娇 胡蝶 张晔 CHEN Jingjing;ZHANG Nianzhi;XUE Xiaoming;HAN Mingxiang;GUAN Wei;SHANG Fang;ZHOU Bobo;MENG Lihong;ZHANG Yanbo;WANG Jiaojiao;HU Die;ZHANG Ye(Shanxi Provincial Hospital of Chinese Medicine,Taiyuan 030012,China;The First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China;Anhui University of Chinese Medicine,Hefei 230038,China;Shanxi University of Chinese Medicine,Taiyuan 030002,China)

机构地区：[1]山西省中医院,山西太原030012 [2]安徽中医药大学第一附属医院,安徽合肥230031 [3]安徽中医药大学,安徽合肥230038 [4]山西中医药大学,山西太原030002

出　　处：《陕西中医药大学学报》2024年第3期48-53,共6页Journal of Shaanxi University of Chinese Medicine

基　　金：国家自然科学基金项目(81774301,82174312);国家重大疑难疾病临床防治中心建设项目(国中药函2014NO.146);山西省高等学校科技成果转化培育项目(202003D31013/GZ);山西省中医药研究院院级课题(202219);山西省自然科学基金面上项目(202203021211048)。

摘　　要：基于叶天士“卫气营血”辨证理论探讨支气管扩张症的治疗。根据支气管扩张症的临床发病特点,结合叶天士“卫气营血”辨证理论的思想特色,认为支气管扩张症证候特点、病机进展是由浅到深的动态变化,临床表现具有温病卫气营血的特点,同时以典型病案加以验证。支气管扩张症初期以温邪外袭卫分为主,当以辛凉疏卫为法,采用银翘散等加减治疗;中期以温邪入里化热伤及气分为主,当以清解痰热、解毒消痈为法,采用麻杏石甘汤及千金苇茎汤等加减治疗;中末期以温邪耗伤营阴为主,当以透热养阴、化痰开窍为法,采用清营汤加减治疗;末期多因失治误治,以温邪伤及血分为主,当以清热凉血、解毒开窍为法,采用犀角地黄汤等加减治疗。叶天士“卫气营血”理论运用于支气管扩张症的辨治,具有可行性,值得临床参考与借鉴。Based on YE Tianshi's“Wei Qi Ying Xue”syndrome differentiation theory,this study explores the treatment of bronchiectasis.Based on the clinical characteristics of bronchiectasis and combined with Ye Tianshi's“Wei Qi Ying Xue”syndrome differentiation theory,it is believed that the syndrome characteristics and pathogenesis of bronchiectasis are dynamic changes from shallow to deep,and the clinical manifestations have the characteristics of warm disease Wei Qi Ying Xue.At the same time,it is verified by classic medical records.In the early stage of bronchiectasis,the main approach is to warm pathogenic factors attacking the external environment.When treating bronchiectasis,the method is to use Xin Liang Shu Wei,and modified treatments such as Yin Qiao powder are used;In the middle stage,the main treatment is to warm pathogenic factors and transform heat and Qi.When clearing phlegm and heat,detoxifying and eliminating carbuncle,modified treatments such as Maxing Shigan decoction and Qianjin Weigan decoction should be used;In the middle and late stages,the main treatment is to warm evil and consume Yin,and when using methods such as heat dissipation,nourishing Yin,resolving phlegm,and opening the orifices,modified Qingying decoction should be used for treatment;In the late stage,there are many reasons for mistreatment,mainly focusing on warming pathogenic factors and blood distribution.When using methods such as clearing heat and cooling blood,detoxifying and opening the orifices,modified treatments such as Xijiao Dihuang decoction should be used.The application of YE Tianshi's“Wei Qi Ying Xue”theory in the diagnosis and treatment of bronchiectasis is feasible and worthy of clinical reference and reference.

关 键 词：卫气营血 叶天士 支气管扩张症 典型病例 

分 类 号：R259[医药卫生—中西医结合]