宣肺败毒方治疗病毒性肺炎的中医理论及药理机制探讨  

Discussion on Traditional Chinese Medicine Theory and Pharmacological Mechanism of Xuanfei Baidu Prescription in Treatment of Viral Pneumonia

作　　者：张益豪 彭鑫 栾哲宇 汪云帆 尚佳琪 封继宏[2] ZHANG Yihao;PENG Xin;LUAN Zheyu;WANG Yunfan;SHANG Jiaqi;FENG Jihong(Tianjin University of Traditional Chinese Medicine(TCM),Tianjin 301617,China;The Second Affiliated Hospital of Tianjin University of TCM,Tianjin 300250,China)

机构地区：[1]天津中医药大学,天津301617 [2]天津中医药大学第二附属医院,天津300250

出　　处：《中国实验方剂学杂志》2024年第19期214-224,共11页Chinese Journal of Experimental Traditional Medical Formulae

基　　金：国家重点研发计划项目(2022YFC3500803)。

摘　　要：病毒性肺炎(VP)是由一种或多种病毒经上呼吸道感染并向下蔓延造成不同程度肺实质损伤的炎性疾病,对社会经济和公共卫生构成严重威胁。目前西医多以对症支持治疗为主,缺少特异性治疗手段,临床仍处于药物缺乏的困境。从中医角度VP属“疫病”范畴,其病因责之于“疫毒、六淫”,“湿、热、毒、虚、瘀”是其病理因素,以“阴阳失衡、脏腑失调、正气亏虚”为基本病机,“扶正祛邪”为其治疗原则,以六经证治为基础立法,辅以卫气营血、三焦理论辨证施治。宣肺败毒方是张伯礼院士与刘清泉教授深入发掘经典文献研究和现代组分优化筛选总结的有效方剂,是“科技+中药”之产物,该方由麻杏石甘汤、麻杏薏甘汤、葶苈大枣泻肺汤、千金苇茎汤及不换金正气散化裁而成,具有宣肺化湿、清热透邪、泻肺解毒之效,治疗疫病之湿毒郁肺证,对防治VP具有一定临床价值。该文综述了宣肺败毒方治疗VP的一系列重要研究进展,探讨其组方结构、用药思路、证治范围及临床新用的中医相关理论,总结其抑制病毒作用、减轻炎症反应、调控免疫系统、改善肺纤维化、调节肠道菌群的药理作用机制,并就研究中存在的问题提出思考与建议,以期为防治VP包括新型冠状病毒肺炎(COVID-19)在内的临床用药及基础研究提供参考。Viral pneumonia(VP)is an inflammatory disease caused by one or more viruses that infect the upper respiratory tract and spread downward.Causing varying degrees of pulmonary parenchymal damage,VP poses a serious threat to the society and public health.The treatment of VP now faces the dilemma of drug shortage,since Western medicine can only alleviate symptoms and lacks specific treatment methods.In traditional Chinese medicine(TCM),VP is assigned as an epidemic disease,with the etiology attributed to epidemic toxin and six excesses and the pathological factors of dampness,heat,toxin,deficiency,and stasis.The basic pathogenesis of VP is Yin-Yang imbalance,dysfunction of Zang-Fu organs,and healthy Qi deficiency.Accordingly,the treatment should follow the principle of replenishing healthy Qi and expelling pathogen.The treatment method of VP is mainly developed based on syndrome differentiation of six meridians,defense-Qinutrient-blood,and triple energizer.Xuanfei Baidu prescription(XFBD)is an effective prescription developed by Academician ZHANG Boli and Professor LIU Qingquan by literature research and selection of multicomponent Chinese medicine.It is the product of modern research combined with TCM.XFBD is modified from Maxing Shigantang,Maxing Yigantang,Tingli Dazao Xiefeitang,Qianjin Weijingtang,and Buhuanjin Zhengqisan.It is mainly used to treat epidemic diseases with the syndrome of dampness toxin stagnating in the lung,with the effects of ventilating lung and resolving dampness,clearing heat and expelling pathogen,purging lung,and removing toxin,demonstrating the potential for the prevention and treatment of VP.This paper reviews the research progress of XFBD in combating VP in terms of the prescription composition,compatibility ideas,indications,and clinical new applications,as well as the pharmacological mechanisms of inhibiting virus,reducing inflammation,regulating immune system,ameliorating pulmonary fibrosis,and modulating intestinal flora.In addition,we put forward our thoughts and suggestions on the p

关 键 词：宣肺败毒方 病毒性肺炎 中医理论 药理作用 作用机制 

分 类 号：R856.2[医药卫生—航空、航天与航海医学] R969.4[医药卫生—临床医学] R242R286R563.1R256.1