从肺肾同治辨治肺间质纤维化

贺晋芳; 张沂; 晏军

doi:10.3969/j.issn.2095-6606.2022.03.009

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从肺肾同治辨治肺间质纤维化

思路与方法 | 更新时间：2022-06-02

- 从肺肾同治辨治肺间质纤维化
- Syndrome differentiation and treatment of pulmonary fibrosis from the perspective of simultaneous treatment of the lung and the kidney
- 现代中医临床 2022年29卷第3期页码：39-42
- 作者机构：
  
  北京中医药大学东直门医院　北京　100700
- 作者简介：
  
  贺晋芳，女，在读博士生
  # 晏军，男，博士，主任医师、博士生导师，E-mail：dzmyyyj@126.com
- 基金信息：
  
  国家自然科学基金项目(81373589);北京中医药大学2021年度基本科研业务费项目(2021-JYB-XJSJJ-086)
- DOI：10.3969/j.issn.2095-6606.2022.03.009
  中图分类号： R259
- 纸质出版日期：2022-05-30，
  
  收稿日期：2021-06-06，
- 稿件说明：
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贺晋芳, 张沂, 晏军. 从肺肾同治辨治肺间质纤维化[J]. 现代中医临床, 2022,29(3):39-42.

Jinfang HE, Yi ZHANG, Jun YAN. Syndrome differentiation and treatment of pulmonary fibrosis from the perspective of simultaneous treatment of the lung and the kidney[J]. Modern Chinese Clinical Medicine, 2022,29(3):39-42.
贺晋芳, 张沂, 晏军. 从肺肾同治辨治肺间质纤维化[J]. 现代中医临床, 2022,29(3):39-42. DOI： 10.3969/j.issn.2095-6606.2022.03.009.

Jinfang HE, Yi ZHANG, Jun YAN. Syndrome differentiation and treatment of pulmonary fibrosis from the perspective of simultaneous treatment of the lung and the kidney[J]. Modern Chinese Clinical Medicine, 2022,29(3):39-42. DOI： 10.3969/j.issn.2095-6606.2022.03.009.

摘要

肺间质纤维化以进行性加重的呼吸困难、咳嗽、低氧血症为临床特征。中医理论认为该病的发生、发展总不离肺肾，肺肾同病是其病变的重要特点。本研究从藏象理论探讨肺间质纤维化中的肺肾关系，其中，肺虚是原发根本病因，肾虚是重要病机。病因病机主要为：卫外失职、气机升降失常、肺肾血水胶结。临床辨治包括：肺肾皆虚，宜补益肺肾、摄虚浮之气；肺肾虚实夹杂，宜补虚泻实；下虚上实，宜补肾泻肺、摄冲逆之气；肾虚邪恋，宜温肾发表、袪外扰之邪。还需注意袪瘀、解毒、清热不能忘；五脏一体贯穿治疗始终；助肺主气为最终导向。

Abstract

Pulmonary fibrosis (PF) is characterized by progressive dyspnea

cough

and hypoxemia. TCM theories believe the occurrence and progress of PF are always inseparable from the lung and kidney

so the simultaneous dysfunction of the two organs is one of the crucial features of the disease. This study explores the lung-kidney correlation in PF based on the theory of visceral manifestation

which reveals that lung deficiency is the primary cause and the kidney deficiency is an important pathogenic factor. Pathogenesis and etiology of PF means: dysfunction of wei qi (defensive qi)

abnormalities in the ascending and descending of qi

and blood stasis and phlegm coagulation caused by lung and kidney deficiency. Syndrome differentiation and treatment include: for the deficiency of both lung and kidney

it is advisable to suffice and nourish the both to control the deficient and floating qi; for the mixture of deficiency and excess in both organs

it is appropriate to supplement deficiency to relieve the excessive syndrome; for the pattern of kidney deficiency and lung excess

it is suggested to supplement the kidney and to clear the lung

to control the counterflow of Chong qi (from the Chong meridian); for the kidney deficiency due to evil persistence

it is better to warm the kidney to disperse the exterior

to banish the evil of external disturbance. Generally

we should focus on dispelling stasis

resolving toxin and clearing heat; emphasizing the integration of the five zang organs throughout the treatment

and finally restoring the qi-governing function of the lung.

关键词

肺肾相关肺间质纤维化肺肾同治辨证论治

Keywords

lung-kidney correlationpulmonary fibrosissimultaneous treatment of the lung and the kidneytreatment based on differentiation of syndromes

references

RAGHU G, MARTINE R, MYERS J L, et al. Diagnosis of idiopathic pulmonary fibrosis——an official ATS/ERS/JRS/ALAT clinical practice guideline[J].Am J Respir Crit Care Med.2018, 198(5):e44-e68.

VANMANEN M J G, GEELHOED J J M, TAK N C, et al. Optimizing quality of life in patients with idiopathic pulmonary fibrosis[J].Therapeutic Advances in Respiratory Disease，2017, 11(3):157-169.

晁恩祥，张纾难.肺痿再辨识[J].北京中医药大学学报，1997, 20(5):14-15.

杨士瀛.仁斋直指方论(附遗补)[M].盛维忠，王致谱，傅芳，等，校注.福州：福建科学技术出版社，1989:277.

沈自尹.“肾的研究”通过“与时俱进”而不断进取[J].中国中西医结合杂志，2015, 35(8):946-949.

王治国，石庆学，郭佳，等.COPD患者肺功能与甲状腺激素水平的相关性分析[J].标记免疫分析与临床，2017, 24(5):516-519.

郑颖文.慢阻肺急性加重期患者甲状腺激素水平与患者肺功能和营养状况的相关性[J].临床肺科杂志，2017, 22(6):1056-1059.

冯畅，施克新，杨梅，等.甲状腺激素水平与更年期综合征女性情绪障碍程度、性激素水平及免疫功能的相关性分析[J].临床和实验医学杂志，2020, 19(24):2654-2657.

赵翀翀，王欢，蔡宏斌，等.糖皮质激素对重症肌无力患者相关免疫机制影响研究[J].中风与神经疾病杂志，2012, 29(10):907-909.

刘赟，樊茂蓉，燕萍.张燕萍治疗特发性肺纤维化经验[J].北京中医药，2014, 33(4):267-268.

黄云鉴，龚婕宁.肺纤维化中医病名、病机及证治规律探析[J].辽宁中医药大学学报，2016, 18(9):98-100.

张介宾.景岳全书集要[M].余瀛鳌，林菁，田思胜，等，编选.沈阳：辽宁科学技术出版社，2007:275-276.

秦景明.症因脉治[M].秦之桢，辑.上海：上海科学技术出版社，1990:104.

王焘.外台秘要[M].高文铸，校注.北京：华夏出版社，1993:172.

张介宾.类经[M].孙国中，方向红，点校.学苑出版社，2005:121.

叶天士.临证指南医案[M].艾军，戴铭，主校.北京：中国中医药出版社，2008:231.

张云松，朱晓林.从解毒化瘀扶正法论治重症特发性肺间质纤维化[J].辽宁中医杂志，2013, 40(1):61-62.

武维屏，任传云.肺间质纤维化中医辨治思路[J].中医杂志，2005, 46(2):139-141.

姜良铎，张晓梅，肖培新.特发性肺间质纤维化的病因病机探讨[J].中华中医药杂志，2008, 23(11):984-986.

林珮琴.类证治裁[M].刘荩文，主校.北京：人民卫生出版社，1988:97.

陈修园.医学从众录[M].宋白杨，校注.北京：中国医药科技出版社，2012:24.

吴谦.医宗金鉴[M].武英殿，排版.北京：人民卫生出版社，1963:418.

袁曼，袁水英，朱琳燕.补肺益肾活血合剂治疗特发性肺间质纤维化的临床研究[J].中医药导报，2017, 23(11):98-100.

陈天明，杨锁平，卢青，等.益气活血调补肺肾法对肺间质纤维化患者肺功能及血清IL-13、TGF-β含量的影响[J].中医药导报，2017, 23(9):96-98.

张爱丽.益肾养肺汤对特发性肺间质纤维化继发慢性呼吸衰竭患者血气分析的影响[J].云南中医中药杂志，2019, 40(6):56-57.

张学燕.从肾论治金水相生治疗特发性肺纤维化经验浅谈[J].河北中医，2014, 36(5):689-690.

JOHNSON M J, BLAND J M, GAHBAUER E A, et al. Breathlessness in elderly adults during the last year of life sufficient to restrict activity: prevalence，pattern，and associated factors[J].J Am Geriatr Soc，2016, 64(1):73-80.

CARVAJALINO S, REIGADA C, JOHNSON M J, et al.Symptom prevalence of patients with fibrotic interstitial lung disease：a systematic literature review[J].BMC Pulm Med，2018, 18(1):78-88.

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