从“络损-络滞-络毒”病机演变探讨肺结节辨治思路  

To explore the differentiation and treatment of pulmonary nodules from the pathogenesis of“collaterals damagecollaterals stagnation-collaterals toxicity”

作　　者：郁文越 朱佳[1] YU Wenyue;ZHU Jia(Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing Jiangsu 210029,China;The First Clinical Medical College of Nanjing University of Chinese Medicine,Nanjing Jiangsu 210029,China)

机构地区：[1]南京中医药大学附属医院,江苏南京210029 [2]南京中医药大学第一临床医学院,江苏南京210029

出　　处：《四川中医》2024年第4期42-45,共4页Journal of Sichuan of Traditional Chinese Medicine

基　　金：第四批江苏省名老中医药专家传承工作室建设项目(苏中医科教[2021]7号)。

摘　　要：从络病理论总结肺结节辨治思路。认为肺结节的发生、发展到恶变的病机演变主要经历正损(络损)、结形(络滞)、恶变(络毒)三个阶段,核心病机分别为气阳不足,肺虚络损;痰瘀凝聚,络滞郁痹;阴结蕴热,络毒亢变;辨治原则主要有益气扶正,温阳通络;化痰祛瘀,散结通络;养阴润肺,解毒通络。并分别从虫类药、藤类药、辛味药、通补药进一步探讨通络药在肺结节中的具体运用,以期为肺结节临床辨治提供参考。The differentiation and treatment of pulmonary nodules were summarized from collateral disease theory.It is concluded that the pathogenesis of pulmonary nodules from occurrence to malignant degeneration mainly goes through three stages:positive lesion(collaterals lesion),nodal shape(collaterals stagnation)and malignant lesion(collaterals toxin).The core pathogenesis is deficiency of Qi Yang and deficiency of lung collaterals.Phlegm stasis condensation,collaterals stagnation stagnation bi;Yin knot accumulated heat,collaterals toxic hyperactivity change;The principle of differentiation and treatment is mainly ben-eficial to fuzheng Qi,warming Yang and clearing collaterals;Dispelling phlegm and stasis,dispersing knots and collaterals;Nourishing Yin and moistening lung,detoxifying and clearing collaterals.The specific application of Tongluo drugs in pulmonary nodules was further discussed from insect drugs,rattan drugs,tangxin drugs and toning drugs,in order to provide reference for clinical differentiation and treatment of pulmonary nodules.

关 键 词：络病理论 肺结节 病机演变 辨治思路 

分 类 号：R563[医药卫生—呼吸系统]