肺结节中医病因病机及辨证思路概述  

Overview of TCM etiology,pathogenesis and syndrome differentiation of pulmonary nodules

作　　者：陆勤丰 陈竹 巫善珩 魏瑜[1] LU Qinfeng;CHEN Zhu;WU Shanheng;WEI Yu

机构地区：[1]南京中医药大学附属医院,江苏南京210029

出　　处：《中医临床研究》2024年第12期62-68,共7页Clinical Journal Of Chinese Medicine

摘　　要：肺癌为我国发生率和病死率高居首位的重大慢性疾病,其早期筛查是改善患者生存预后的关键,肺部结节目前被认为是早期肺癌和肺癌前病变的主要征象。随着影像设备与技术的进步和人们健康意识的提高,普通胸片现已不能满足医生对于筛查早期肺癌时肺部出现微小变化的需求,尤其是新型冠状病毒感染后,愈来愈多的人关注肺部疾病,肺部结节的检出率日渐增多,引起人们的高度重视。现代医学对于早期肺结节多采取以定期复查为主的管理手段,困于“易检难治”的局面。而中医药作为我国的文化瑰宝,其理论的核心在于辨证论治,但大部分肺结节患者在临床上并无相关症状特征,这让中医的治疗陷入“无证可辨”的尴尬境地。通过检索数据库中近5年的肺结节中医辨治相关期刊文献,发现中医药对于肺结节的早期防治以及遏制其恶性进展具有一定优势。文章根据不同医家辨治肺结节的思路和方法,总结了肺结节以外邪侵袭、肝气郁结、湿痰瘀阻为特点的中医病因病机,以及以体质、微观、中西医结合、肺络等角度为核心的辨证思路,以期在西医建议的随访观察的“空窗期”或有创操作前后进行中医药控制与干预,结合中医“治未病”的理念,发挥中医药的特色优势,为肺癌早期治疗提供临床思路。Lung cancer is a major chronic disease with the highest incidence and mortality in China,and its early screening is the key to improve the survival and prognosis of patients.Pulmonary nodules are currently considered to be the main signs of early lung cancer and prelung cancer.With the progress of imaging equipment and technology and the improvement of people’s health awareness,ordinary chest radiographs can no longer meet doctors’demand for small changes in the lungs during screening for early lung cancer.Especially after corona virus disease 2019,more and more people pay attention to lung diseases,and the detection rate of pulmonary nodules is increasing,which attracts people’s great attention.Modern medicine usually adopts regular review as the main management method for early pulmonary nodules,which is trapped in the situation of“easy detection but difficult treatment”.As the cultural treasure of our country,the core of TCM theory lies in syndrome differentiation and treatment,but most patients with pulmonary nodules have no relevant symptoms in clinical practice,which makes the treatment of TCM fall into an awkward situation of“no identification”.By searching the journal literature related to TCM diagnosis and treatment of pulmonary nodules in the recent 5 years in databases,it is found that TCM has certain advantages in the early prevention and treatment of pulmonary nodules and the suppression of their malignant progression.According to different doctors’ideas and methods of distinguishing and treating pulmonary nodules,this paper summarizes the etiology and pathogenesis of pulmonary nodules characterized by invasion of external pathogens,stagnation of liver Qi(气)and dampness of phlegm and blood stasis,as well as the syndrome differentiation ideas based on constitution,microscopic,integrated TCM and Western medicine,lung callaterals,etc.,with a view to carrying out TCM control and intervention during the“window period”or before and after invasive operation recommended by Western medic

关 键 词：肺结节 病因病机 辨治方法 总结概述 

分 类 号：R256.1[医药卫生—中医内科学]