基于“伏邪”论治瘢痕性气道狭窄  

Treatment of scarring airway stenosis based on “hidden pathogen”

作　　者：洪沁妍 吕明圣 吴华阳[1] 滕俊 南富耀 孟涵 王洪武 HONG Qinyan;LYU Mingsheng;WU Huayang;TENG Jun;NAN Fuyao;MENG Han;WANG Hongwu(Department of Respiratory,Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing100700,China;Department of Respiratory,Tsinghua University Yuquan Hospital,Beijing100040,China)

机构地区：[1]北京中医药大学东直门医院呼吸科,北京100700 [2]清华大学玉泉医院呼吸科,北京100040

出　　处：《中国医药导报》2025年第8期165-168,共4页China Medical Herald

基　　金：中国博士后科学基金第73批面上资助项目(2023M730344)。

摘　　要：瘢痕性气道狭窄(SAS)是一种常见的良性气道狭窄类型,其发病率逐年上升。现代医学治疗以经支气管镜介入为主,但其并发症和再狭窄风险不容忽视。该团队基于“伏邪”理论认为,“肺气虚,痰瘀伏,遇诱发”是SAS的核心病机,临床辨治SAS应注重辨“伏邪”的“伏”与“发”,着眼于痰瘀,分阶段诊疗。对SAS风险群体,应侧重匡扶正气以预防“伏邪”内藏;针对瘢痕性狭窄已形成群体,则着重祛痰散瘀以促进“伏邪”外出;对疾病反复发作群体,应间者并行,扶正与祛邪并进以阻断“伏邪”深根。本文旨在为SAS的中医临床诊疗提供新的思路和方法,以期预防SAS复发,延长气道再狭窄时间,改善患者预后。Scarring airway stenosis(SAS)is a common type of benign airway narrowing,with an increasing incidence rate annually.Modern medical treatment primarily involves interventional bronchoscopy,yet complications and risks of restenosis cannot be ignored.Based on“hidden pathogen”theory,the team identifies“lung qi deficiency,phlegm and blood stasis hidden,and encountered”as the core pathogenesis of SAS,clinical differentiation and treatment of SAS should focus on distinguishing“hidden pathogen”of“hidden”and“active”,with emphasis on phlegm and blood stasis,and phased treatment.For high-risk SAS populations,reinforcing healthy qi is crucial to prevent“hidden pathogen”accumulation;for those with established scar stenosis,emphasis is on dispelling phlegm and dissipating blood stasis to expel“hidden pathogen”;for recurrent cases,simultaneous application of principal and subordinate treatments,a concurrent approach of strengthening vital qi to eliminate pathogenic factor is employed to block deep-seated“hidden pathogen”.This article aims to provide new perspectives and methods for traditional Chinese medicine clinical diagnosis and treatment of SAS,with the goal of preventing SAS recurrence,prolonging airway restenosis time,and improving patient’s prognosis.

关 键 词：瘢痕性气道狭窄 “伏邪”理论 病因病机 治法治则 理论探讨 

分 类 号：R256.1[医药卫生—中医内科学]