从“温肺阳、护阴肤”理论出发论治慢性支气管炎  

Treatment of Chronic Bronchitis Based on Theory of"Warming Lung Yang and Protecting Yin Skin"

作　　者：鲁振 刘庆银[2] 姚卫卫 陶伟伟[1] 刘丽娜[1] 裴可 LU Zhen;LIU Qingyin;YAO Weiwei;TAO Weiwei;LIU Lina;PEI Ke(School of Integrated Chinese and Western Medicine,Nanjing University of Chinese Medicine,Nanjing 210023,China;College of Rehabilitation Medicine,Shandong University of Traditional Chinese Medicine(TCM),Jinan 250355,China;Dezhou Hospital of TCM,Dezhou 253000,China)

机构地区：[1]南京中医药大学中西医结合学院,南京210023 [2]山东中医药大学康复医学院,济南250355 [3]德州市中医院,山东德州253000

出　　处：《中国实验方剂学杂志》2024年第15期215-223,共9页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家自然科学基金青年基金项目(82305122);南京中医药大学罗林秀科研基金项目(LLX202206);江苏省中医药科技发展计划项目(QN202201);江苏省科技计划项目(BK20230450)。

摘　　要：慢性支气管炎是一种常见的呼吸系统疾病,可归为中医学肺系疾病范畴,与肺的功能失调关系密切。肺阳为肺之阳气,是肺脏生理活动的原动力,具有温煦肺系、敷布肺津、宣散卫阳等生理功能,可经玄府流通气液布散于气道阴肤表面,发挥顾护、濡养作用。若卫阳失于顾护阴肤,或肺津不能濡养阴肤,导致气道阴肤的结构损伤,其肃清痰浊、布散肺津、抵御外邪等功能减退,痰浊留滞、阴肤失濡与外邪侵袭,均能耗伤肺阳、灼伤肺津,加剧阴肤失护的病理状态,形成恶性循环,终成肺阳虚损,导致慢性支气管炎发生。笔者从“阴肤失护”与“肺阳虚损”的内在联系切入,对慢性支气管炎病因病机进行解读,提出气道“阴肤失护”是慢性支气管炎发生的基本病因,在此基础上导致的“肺阳虚损”是慢性支气管炎的核心病机,并将微观辨指标与宏观辨证候结合,探讨其现代生物学基础。并在“温肺阳、护阴肤”理论的指导下,以现代药理学研究为基础,进一步探究单味中药及中药复方“温肺阳、护阴肤”调治慢性支气管炎的科学内涵,提出急性加重期祛邪护阴肤、缓解期扶正温肺阳的运用方法,以期为慢性支气管炎的早期防治拓展新思路。Chronic bronchitis(CB)is a common respiratory system disease that is classified as a lung disease in traditional Chinese medicine(TCM)and is closely related to lung dysfunction.Lung Yang is the Yang Qi of the lungs,which drives the physiological activities within the lungs.It has physiological functions such as warming the lung system,regulating lung fluid,and dispersing the protective Yang.It can be distributed on the surface of the airway's Yin skin through sweat pores in the form of airflow and fluid,playing a protective and nourishing role.If the protective Yang fails to guard the Yin skin or if the lung fluid cannot nourish the Yin skin,the structural integrity of the airway's Yin skin may be compromised.This may weaken lung Yang's functions,such as clearing phlegm turbidity,dispersing lung fluid,and resisting external pathogens.Consequently,the retention of phlegm turbidity,insufficient nourishment of the Yin skin,and invasion by external pathogens all damage the lung Yang,burn the lung fluid,and exacerbate the pathological state of Yin skin unprotected,forming a vicious cycle that ultimately results in lung Yang asthenia and then the onset of CB.Based on the intrinsic connection between"Yin skin unprotected"and"lung Yang asthenia",this paper interprets the etiology and pathogenesis of CB.It proposes that"Yin skin unprotected"in the airway is the basic cause of CB and"lung Yang asthenia"caused by"Yin skin unprotected"is the core pathogenesis of CB.By integrating micro differentiation indicators with macro differentiation syndromes,the study explores its modern biological basis.Guided by the theory of"warming the lung Yang and protecting the Yin skin"and based on modern pharmacology research,this study further explores the scientific connotation of single TCM and compound formulations for treating TCM by warming the lung Yang and protecting the Yin skin.Furthermore,it proposes methods for dispelling pathogenic factors and protecting the Yin skin during the acute exacerbation phase,as well as nourishing and w

关 键 词：慢性支气管炎 阴肤失护 肺阳虚损 温肺阳 护阴肤 

分 类 号：R242[医药卫生—中医临床基础] R22[医药卫生—中医学] R289R563R256.1