以窠囊理论探析气管切开术后并发肉芽组织增生的治疗  

Treatment of Granulation Tissue Hyperplasia after Tracheostomy Based on the Kenang (窠囊) Theory

作　　者：袁月 雷斯媛 王佳佳[1,2] 李建生 YUAN Yue;LEI Siyuan;WANG Jiajia;LI Jiansheng(Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases Co-constructed by Henan Province&Education Ministry of P.R.China/Henan Key Laboratory of Chinese Medicine for Respiratory Diseases,Henan University of Chinese Medicine,Zhengzhou,450046;The First Affiliated Hospital of Henan University of Chinese Medicine;The First Clinical Medical College of Henan University of Chinese Medicine)

机构地区：[1]河南中医药大学呼吸疾病中医药防治省部共建协同创新中心/河南省中医药防治呼吸病重点实验室,河南省郑州市450046 [2]河南中医药大学第一附属医院 [3]河南中医药大学第一临床医学院

出　　处：《中医杂志》2025年第7期746-749,共4页Journal of Traditional Chinese Medicine

基　　金：国家中医药管理局全国名老中医药专家传承工作室(国中医药人教函[2022]75号);国家中医药管理局国家中医药传承创新团队项目(ZYYCXTD-C-202206);河南省中原学者科学家工作室项目(豫财行[2018]204号);河南省“双一流”创建学科中医学科学研究专项(HSPR-DFCTCM-2023-2-01)。

摘　　要：气管切开术后并发肉芽组织增生是临床常见并发症。经电子支气管镜治疗可短期缓解气道阻塞,但存在复发率高、远期预后不佳等问题。基于中医“窠囊”理论,结合现代病理机制,探讨其与气管切开术后肉芽增生的病机联系,并总结运用窠囊理论治疗气管切开术后并发肉芽组织增生的经验,认为本病病机以正气亏虚、脏腑功能失调为本,痰瘀互结为标。提出化痰活血、散结消积,宣达气机、疏壅通滞,固本培元、扶正祛邪的治疗思路,使痰瘀得化,窠囊消散,以达防治肉芽组织增生之效。Granulation tissue hyperplasia after tracheotomy is a common clinical complication.Endoscopic treatment can temporarily relieve airway obstruction,however,it is associated with a high recurrence rate and poor long-term prognosis.Based on the traditional Chinese medicine(TCM)Kenang(窠囊)theory and combined with modern pathological mechanisms,this paper explores its correlation with the pathogenesis of post-tracheotomy granulation tissue hyperplasia.Drawing from clinical experience in applying the Kenang theory for treatment,this paper proposes that the fundamental pathogenesis of this condition lies in qi deficiency and organ dysfunction,while phlegm and blood stasis interlocking serve as the symptomatic manifestations.The treatment focuses on resolving phlegm and promoting blood circulation,dispersing nodules and eliminating stagnation,regulating qi flow,and reinforcing the body's vital energy while expelling pathogenic factors.This approach aims to dissolve phlegm and blood stasis,dissipate the Kenang,and ultimately prevent and treat granulation tissue hyperplasia.

关 键 词：气管切开术 肉芽组织增生 窠囊理论 痰瘀互结 

分 类 号：R256.1[医药卫生—中医内科学]