韩明向分期分证治疗慢性阻塞性肺疾病经验  

HAN Mingxiang's Experience in Staged and Syndrome-Based Treatment of Chronic Obstructive Pulmonary Disease

作　　者：丁健 陶慧 程刚[1,2] 郭为振 李泽庚 毛娅 韩明向(指导)[1,2,3] DING Jian;TAO Hui;CHENG Gang;GUO Weizhen;LI Zegeng;MAO Ya(Anhui University of Chinese Medicine,Hefei,230038;The First Affiliated Hospital of Anhui University of Chinese Medicine;Institute of Traditional Chinese Medicine Respiratory Disease Prevention and Treatment,Anhui Academy of Traditional Chinese Medicine;Hospital of Traditional Chinese Medicine of Ankang City,Shaanxi Province)

机构地区：[1]安徽中医药大学,安徽省合肥市230038 [2]安徽中医药大学第一附属医院 [3]安徽省中医药科学院中医呼吸病防治研究所 [4]陕西省安康市中医医院

出　　处：《中医杂志》2025年第8期780-785,共6页Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金(82374399);国家自然科学基金区域创新发展联合基金重点支持项目(U20A20398);安徽省科学技术厅临床医学研究转化专项(202204295107020045)。

摘　　要：总结韩明向教授治疗慢性阻塞性肺疾病(COPD)的临证经验。认为外邪侵袭引动宿疾是COPD急性加重期的关键病机,肺气虚是稳定期的关键病机,“虚、痰、瘀”为疾病发展过程中的核心病理要素。治疗上强调分期分证论治,急性加重期中,针对风寒袭肺证,自拟三子温肺汤以解表散寒、温肺化痰;针对痰湿蕴肺证,自拟化痰降气方以温肺化痰、降气平喘;针对痰热壅肺证,自拟清肺化痰方以清热化痰、润肺止咳;针对痰瘀互结证,自拟芪白平肺方以益气化痰、活血化瘀。稳定期中,针对肺气虚证,自拟参芪温肺汤以温肺益气、化痰泻浊;针对肺脾气虚证,自拟参芪补中汤以健脾益气、培土生金;针对肺肾亏虚证,自拟参芪调肾方以补肺温阳、纳肾平喘,为COPD中医治疗提供思路。This paper summarizes Professor HAN Mingxiang's clinical experience in treating chronic obstructive pulmonary disease(COPD).He believes that the key pathomechanism of COPD in the acute exacerbation stage is the invasion of external pathogens triggering latent illness,while lung qi deficiency is the primary mechanism in the stable stage.The core pathological factors throughout disease progression are deficiency,phlegm,and blood stasis.Treatment emphasizes a staged and syndrome-based approach.During the acute exacerbation stage,for wind-cold invading the lung syndrome,the self-formulated Sanzi Wenfei Decoction(三子温肺汤)is used to relieve the exterior,dispel cold,warm the lung,and resolve phlegm.For phlegm-dampness obstructing the lung syndrome,Huatan Jiangqi Fomulation(化痰降气方)is prescribed to warm the lung,transform phlegm,descend qi,and calm wheezing.For phlegm-heat obstructing the lung syndrome,Qingfei Huatan Fomulation(清肺化痰方)is applied to clear heat,resolve phlegm,moisten the lung,and stop coughing.For phlegm and blood stasis interlocking syndrome,Qibai Pingfei Fomulation(芪白平肺方)is used to tonify qi,resolve phlegm,and activate blood circulation to remove stasis.During the stable stage,for lung qi deficiency syndrome,Shenqi Wenfei Decoction(参芪温肺汤)is employed to warm the lung,tonify qi,resolve phlegm,and eliminate turbidity.For lung-spleen qi deficiency syndrome,Shenqi Buzhong Decoction(参芪补中汤)is utilized to strengthen the spleen,tonify qi,and reinforce metal(lung)from earth(spleen).For lung-kidney deficiency syndrome,Shenqi Tiaoshen Fomulation(参芪调肾方)is prescribed to tonify the lung,warm yang,and regulate kidney function to calm wheezing.These strategies provide insights into the traditional Chinese medicine treatment of COPD.

关 键 词：慢性阻塞性肺疾病 肺胀 名医经验 韩明向 

分 类 号：R256.1[医药卫生—中医内科学]