基于“窠囊理论”探讨非结核分枝杆菌肺病临证思路  

Clinical approaches to non-tuberculous mycobacterial pulmonary disease based on the"Ke'nang theory"

作　　者：陈传链 陈书逸 尹良胜[2] CHEN Chuanlian;CHEN Shuyi;YIN Liangsheng(The Second Clinical School of Zhejiang Chinese Medical University,Hangzhou 310053,China;Tuberculosis Department,Zhejiang Hospital of Integrated Traditional Chinese and Western Medicine,Hangzhou 310003)

机构地区：[1]浙江中医药大学第二临床医学院,杭州310053 [2]浙江省中西医结合医院结核科,杭州310003

出　　处：《北京中医药》2025年第4期520-523,共4页Beijing Journal of Traditional Chinese Medicine

摘　　要：“窠囊理论”于明清时期形成了较为完善的体系。窠囊病位主在肺,“窠囊理论”与非结核分枝杆菌肺病在病因病机病位、病变形态、疾病预后等方面有高度重合性,非结核分枝杆菌肺病根源于正气虚弱,发展于火盛浊逆,成窠成痨于痰瘀血互结。立足于湿、热、痰、瘀、虚等病机要点,以喻嘉言“静以驭气”“严以驭脾”为基本治则,以升降气机,恢复脾肺功能;调理湿热痰瘀,稳定痨虫窠囊;固元培本,巩固人体正气等为治疗大法。为中医治疗非结核分枝杆菌肺病提供了新思路、新方法。The"Ke'nang theory"was formed as a relatively complete system during the Ming and Qing dynasties.The primary disease location of Ke'nang is in the lungs,with qi as the root cause of the disease.The"Ke'nang theory"shares a high degree of overlap with non-tuberculous mycobacterial pulmonary disease in terms of etiology,pathogenesis,disease location,pathological changes,and prognosis.Non-tuberculous mycobacterial pulmonary disease originates from weakened healthy qi and develops due to the exuberant fire and turbidity reversal,leading to the formation of tuberculosis-like lesions from the mutual entanglement of phlegm,blood stasis,and stagnation.Focusing on key pathogenic factors such as dampness,heat,phlegm,stasis,and deficiency,and following the basic treatment principles of"calming to control qi"and"strictly regulating the spleen"as proposed by YU Jiayan,the treatment aims to ascend and descend qi,restore spleen and lung functions,adjust dampness,heat,phlegm,and stasis,stabilize Ke'nang lesions caused by tuberculosis parasites,consolidate and bank up origin,and strengthen the body's healthy qi.This provides a new perspective and approach for the treatment of non-tuberculous mycobacterial pulmonary disease in traditional Chinese medicine.

关 键 词：窠囊理论 非结核分枝杆菌肺病 痰瘀互结 肺痨 病因病机 

分 类 号：R259[医药卫生—中西医结合]