祛瘀生新法防治放射性肺纤维化  

Prevention and Treatment of Radiation-Induced Pulmonary Fibrosis by the Method of Dispelling Stasis to Promote Regeneration

作　　者：张兰鑫 胡帅航 王家伟[1] 周彤 侯炜[1] ZHANG Lanxin;HU Shuaihang;WANG Jiawei;ZHOU Tong;HOU Wei(Guang'anmen Hospital,China Academy of Chinese Medical Sciences,Beijing,100053;Beijing University of Chinese Medicine)

机构地区：[1]中国中医科学院广安门医院,北京西城100053 [2]北京中医药大学

出　　处：《中医杂志》2024年第10期1077-1081,共5页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82074239);中国中医科学院科技创新工程项目(CI2021A01801,CI2021B009);国家发展和改革委员会专项基金子项目。

摘　　要：瘀血是贯穿放射性肺纤维化病变全程的重要病理因素,存在由新成到久滞的演变过程,治疗应将祛瘀生新法贯穿始终。认为热毒消烁气阴、正虚血行瘀滞为放射性肺纤维化发病之基,伏火内灼肺络、痰瘀互结互阻为发病之渐,经络营卫气伤、瘀血久化干血为发病之要。主张放射治疗期间,重视透热润燥益气阴,养血和血疏瘀滞,以“未病先防”;若出现放射性肺炎,则侧重化痰祛瘀清伏火,通络解结畅脉道,以“既病防变”;若发展至放射性肺纤维化,则以缓中补虚培元气,祛瘀生新疗干血为主,以“已病防进”,以期为临床治疗提供参考。Blood stasis is an important pathological factor throughout the whole course of radiation-induced pulmonary fibrosis,which could evolve from new into long stagnation,and the methods of dispelling stasis to promote regeneration should throughout the whole disease progress.It is believed that the basis of the radiation-induced pulmonary fibrosis is heat toxin dispersing qi and yin,and deficiency of healthy qi promoting blood stasis.The process of the disease showed latent fire burning pulmonary collaterals,and the binding of phlegm and stasis.The key factors of the disease were the damage of ying-wei(营卫)qi in channels and collaterals,as well as the blood stasis evolving into dried blood.It is suggested that during radiotherapy,we should pay more attention to relieve heat,moisten dryness,supplement qi and yin,nourish and harmonize blood,and remove blood stasis,so as to prevent disease before it arises.If there is radiation pneumonia,we could focus on dissolving phlegm,removing blood stasis,clearing latent fire,and unblocking the collaterals and veins,in order to"control the development of existing disease".If it develops into radiation-induced pulmonary fibrosis,we could relive the center and supplement deficiency,tonify original qi,dispel stasis to promote regeneration,and clear dried blood,for the purpose of slowing the progression of disease.These ideas might provide reference for clinical treatment.

关 键 词：放射性肺纤维化 放射性肺损伤 祛瘀生新 瘀血 

分 类 号：R273[医药卫生—中西医结合]