刘松江教授基于“土枢四象”理论辨证论治肺结节经验  

Professor Liu Songjiang’s experience in syndrome differentiation and treatment of pulmonary nodules based on the theory of“soil pivot four organs”

作　　者：张悦[1] 王雪慧[2] 陈叶 刘松江[3] ZHANG Yue;WANG Xuehui;CHEN Ye;LIU Songjiang(The First Clinical Medical College,Heilongjiang University of Chinese Medicine,Heilongjiang Province,Harbin 150040,China;Department of Respiratory Medicine,the First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Heilongjiang Province,Harbin 150040,China;Department of Oncology,the First Affiliated Hospital of Heilongjiang University of Chinese Medicine,Heilongjiang Province,Harbin 150040,China)

机构地区：[1]黑龙江中医药大学第一临床医学院,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第一医院呼吸科,黑龙江哈尔滨150040 [3]黑龙江中医药大学附属第一医院肿瘤科,黑龙江哈尔滨150040

出　　处：《中国医药导报》2025年第2期154-157,共4页China Medical Herald

基　　金：黑龙江省中医药管理局省级名中医专家传承工作室建设项目;黑龙江省中医药科研项目(GY2022-05);黑龙江省2023年青年岐黄学者培养项目。

摘　　要：肺结节归属中医“窠囊”“积聚”的范畴,多数医家认为,该病以本虚标实、虚实夹杂为主要病机,脾、肺、肾三脏虚损是本虚,痰饮、气滞、瘀血为标实。“土枢四象”理论源自《四圣心源》,其内涵为脾居人体中央,是气机升降的基础,也是其余四脏之气循环流转、发挥生理功能的保证。刘松江教授基于“土枢四象”理论认为,肺结节以脾土虚损为本源,其病机为脾胃虚损,肺肾失养,水液内生,聚而成痰,肝郁气滞,痰瘀互结,终成窠囊,治疗应以补益脾气为主,兼以祛痰散瘀、调理他脏。本文对刘教授辨证论治肺结节的经验加以总结、凝练,以期为治疗该病提供有益参考。Pulmonary nodules belong to the category of“cysts”and“amassment and accumulation”in traditional Chinese medicine.Most doctors believe that the main pathogenesis of this disease is deficiency in origin and excess in superficislity,intermingled deficiency and excess.Deficiency of spleen,lung,and kidney is deficiency in origin,phlegm,qi stagnation,and blood stasis are excess in superficislity.Theory of“soil pivot four organs”originates from Sisheng Xinyuan,which means that spleen is located in the center of human body,it is the foundation for lifting and lowering of qi movement,as well as the guarantee for circular flow and exploit physiological functions of the other four organs.Professor Liu Songjiang,based on the theory of“soil pivot four organs”,believes that pulmonary nodules originate from spleen and soil deficiency,pathogenesis is spleen and stomach deficiency,loss of lung and kidney nourishment,internal generation of water and fluid,accumulation of phlegm,liver depression and qi stagnation,phlegm and blood stasis accumulation,and ultimately forming cysts.Treatment should mainly focus on tonifying spleen qi,while also eliminating phlegm,dispersing blood stasis,and regulating other organs.This article summarizes and condenses Professor Liu’s experience in syndrome differentiation and treatment of pulmonary nodules,in order to provide useful references for the treatment of this disease.

关 键 词：肺结节 “土枢四象” 经验总结 刘松江 

分 类 号：R249[医药卫生—中医临床基础]