徐艳玲教授诊疗肺间质纤维化经验探析  

Analysis of Professor Xu Yanling′s experience in treating pulmonary interstitial fibrosis

作　　者：王国力[1] 邓虎[1] 徐艳玲[1] Wang Guoli;Deng Hu;Xu Yanling(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang Liaoning 110032)

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《山西中医药大学学报》2024年第11期1248-1252,共5页Journal of Shanxi University of Chinese Medicine

基　　金：第七批全国名老中医药专家学术经验继承工作项目。

摘　　要：肺间质纤维化是多种肺系疾病的终末期改变,病情多呈慢性、渐进性进展,其发病机制尚不够明晰,患病率和病死率日益增高。中医药在应对这一疾病过程中,发挥着独特的优势,不仅能够有效缓解患者的临床症状,还能在一定程度上延缓疾病的进展速度,进而提升患者的生活质量。徐艳玲教授,辽宁省名中医,从事呼吸系统疾病的诊治40余载,有着丰富的临床诊疗经验。徐艳玲教授结合古代文献记载,推崇以“肺痹”“肺痿”认识肺间质纤维化。肺肾气阴两虚是肺间质纤维化发病的基础,正虚不运日久,津失输布,成饮酿痰,阻滞气机,肺失宣降,形成痰浊瘀血等有形实邪阻滞肺络,痰浊瘀血之标实为肺痹发病之机。肺间质纤维化本于肺肾气阴两虚,日久津亏液竭,虚火灼肺,肺络失养,肺叶焦枯而萎弱失用;或本虚日久,酿生之痰浊瘀血,化热酿毒,灼伤肺络,终成肺叶枯萎不荣之象,谓疾病之本虚为肺痿发病之机。其病机肺肾两虚是本,痰浊瘀血阻肺为标,外邪侵袭是疾病恶化要因,提出益气养阴以治其本、化瘀消痰以治其标、参以扶正祛邪的治疗大法。Pulmonary interstitial fibrosis is the end-stage change of many pulmonary diseases.Most of the diseases are chronic and progressive.Its pathogenesis is still unclear enough,and the morbidity and mortality are increasing day by day.Traditional Chinese medicine plays a unique advantage in dealing with this disease,which can not only effectively alleviate the clinical symptoms of patients,but also delay the progress of the disease to a certain extent,thus improving the quality of life of patients.Professor Xu Yanling,a famous TCM doctor in Liaoning Province,has been engaged in the diagnosis and treatment of respiratory diseases for more than 40 years and has rich clinical experience.Combining with the ancient literature,Prof.Xu Yanling advocates recognizing pulmonary interstitial fibrosis from“fei bi”and“fei wei”.Both deficiency of Qi and Yin in lung and kidney is the root cause of pulmonary interstitial fibrosis.The prolonged deficiency of the healthy-Qi leads to poor distribution of body fluids and generation of phlegm-fluid retention,which obstruct the Qi activity.The impaired dispersing and descending of the lung causes the generation of phlegm and blood stasis to block the lung collaterals.The pathogenesis of“fei bi”is phlegm and blood stasis as the manifestation of the disease.Pulmonary interstitial fibrosis is caused by both deficiency of Qi and Yin in lung and kidney.Prolonged insufficiency of body fluids causes the deficiency-fire to burn the lung,and the loss of nourishment in lung collaterals,producing shriveled and weak lung lobes.Or prolonged deficiency of the root leads to the generation of phlegm and blood stasis,which transform into the heat-toxicity to burn the lung collaterals,finally producing shriveled and weak lung lobes.This is the pathogenesis of“fei wei”based on the rootdeficiency.The pathogenesis is both deficiency of lung and kidney as the root cause and blocked lung collaterals by phlegm and blood stasis as the manifestations.The invasion of exogenous pathogens is the main

关 键 词：肺间质纤维化 思想经验 肺痹 肺痿 病因病机 治法 

分 类 号：R256.19[医药卫生—中医内科学] R563.13[医药卫生—中医学]