张伯礼教授基于“散结软坚”分期防治肺结节经验  

Professor ZHANG Boli’s experience in preventing and treating pulmonary nodules based on the method of“softening hardness and resolving masses”

作　　者：季宏昌 黄湘龙 王佳宝 金鑫瑶 闫景贤 李霄 JI Hongchang;HUANG Xianglong;WANG Jiabao;JIN Xinyao;YAN Jingxian;LI Xiao(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion,Tianjin 300381,China;Institute of Traditional Chinese Medicine,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;Evidence-Based Medicine Center,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China;Haihe Laboratory of Modern Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津中医药大学第一附属医院,国家中医针灸临床医学研究中心,天津300381 [2]天津中医药大学中医药研究院,天津301617 [3]天津中医药大学循证医学中心,天津301617 [4]现代中医药海河实验室,天津301617

出　　处：《天津中医药》2025年第5期545-549,共5页Tianjin Journal of Traditional Chinese Medicine

基　　金：现代中医药海河实验室基于组分中药理念瓣化痰散结中药新药研发;国家中医药管理局国医大师传承工作室建设项目。

摘　　要：总结张伯礼教授基于“散结软坚”分期防治肺结节的临证经验。认为肺结节可从“结坚”论治,遵循多层次分期辨识肺结节的演变规律,以正气亏虚为发病之始,情志怫郁为发病之枢,痰结瘀浊为发病之变。以“散结软坚”为基础贯穿分期证治始终,初期宜散结为先,治重痰与气;晚期宜软坚为要,治以痰与瘀,同时立以清肺泻热、活血祛痰、补虚扶正等多种治法,强调形神并摄,从而达到肺络调和目的,为肺结节的中医辨治提供新的思路参考。Summarizing Professor ZHANG Boli’s clinical experience in preventing and treating lung nodules based on the staged approach of“dispersing knots and softening hardness.”It is believed that lung nodules can be treated from the theory of“Jiejian”,following the multi-level staged identification of the evolution of lung nodules,with deficiency of positive qi as the beginning of the disease,fries and depression as the pivot of the disease,and phlegm stagnation and stagnation as the change of the disease.Based on the principle of“dispersing knot and softening hardness”,the staged treatment is always carried out.In the early stage,dispersing knot is the priority,treating phlegm and qi;in the late stage,softening hardness is the most important,treating phlegm and blood,and at the same time,various treatments such as clearing lungs and removing heat,invigorating blood,dispelling phlegm,and tonifying the deficiency and supporting the correctness of the lungs are established to emphasize on form and spirit and to take in the lungs to achieve the goal of regulating lung and lung collaterals and providing a new way of thinking for the Chinese medicine diagnosis and treatment of lung nodules.This will offer new ideas for reference in identifying and treating lung nodules in Chinese medicine.

关 键 词：肺结节 散结软坚 名医经验 张伯礼 

分 类 号：R563[医药卫生—呼吸系统]