基于“伏寒”理论分期辨治慢性阻塞性肺疾病  

Staged Diagnosis and Treatment of Chronic Obstructive Pulmonary Disease Based on the“Latent Cold”Theory

作　　者：王安安 李燕兰 马成勇 张天嵩[2] WANG An'an;LI Yanlan;MA Chengyong;ZHANG Tiansong(Jing'an Hospital of Traditional Chinese Medicine,Shanghai 200072,China;Jing'an District Central Hospital,Fudan University,Shanghai 200040,China)

机构地区：[1]上海市静安区中医医院,上海200072 [2]复旦大学附属静安区中心医院,上海200040

出　　处：《中国中医药信息杂志》2025年第4期168-172,共5页Chinese Journal of Information on Traditional Chinese Medicine

基　　金：上海市静安区名老中医专家传承创新工作室建设项目(JA2021-MLZZ05);上海市静安区卫生科研课题(2023ZY05);上海市静安区中医药临床重点专科建设项目(JA2024-Z009)。

摘　　要：慢性阻塞性肺疾病早期症状隐匿,发生发展乃病邪渐进积聚的过程,临床具有阳虚阴伤的表现,其发病特征与伏寒致病特点的隐匿性、积聚性、伤阳性相契合。伏寒贯穿慢性阻塞性肺疾病病程始终,气阳亏虚是伏寒产生之基,外寒引动诱发伏寒发作,伏寒内聚为病情进展之要。临证主张根据临床表现及伏寒变化特点进行分期论治。急性发作期外寒侵袭、伏寒妄动,治以温宣达邪;慢性稳定期气阳亏虚、伏寒潜藏,治以温补气阳;渐进加重期伏寒久羁、痰瘀互结,治以温消并举。The early symptoms of chronic obstructive pulmonary disease(COPD)are insidious,and its occurrence and development are a gradual accumulation of pathogenic factors.Clinically,it exhibits symptoms of yang deficiency and yin injury,and its pathogenic characteristics are consistent with the insidious,accumulative and injury positive characteristics of the latent cold.“Latent cold”runs through the entire course of COPD.Qi-yang deficiency is the basis for the production of latent cold,external cold triggers the onset of latent cold and the cohesion of latent cold is the key to its onset.The clinical practice advocates for staged treatment based on clinical manifestations and the characteristics of changes in latent cold.During the acute phase of the attack,external cold invasion occurs and there is excessive movement due to the presence of cold.Treatment is based on warming and promoting the spread of pathogenic factors;during chronic stable period,warming and supplementing qi yang should be adopted;during the gradual aggravation period,the patients are prone to prolong chilliness and stagnation with phlegm and blood stasis forming.The treatment is based on a combination of warming and cooling.

关 键 词：慢性阻塞性肺疾病 伏寒 病因病机 分期辨治 

分 类 号：R259.63[医药卫生—中西医结合]