柴苓降气汤辨治慢性阻塞性肺疾病急性加重临床体会

Clinical experience of Chailing Jiangqi Decoction in treating acute exacerbation chronic obstructive pulmonary disease

归纳“调畅气机,化痰通腑”辨治慢性阻塞性肺疾病(COPD)急性发作并发胃肠功能障碍的理论依据,及运用柴苓降气汤,即大柴胡汤合苓甘五味姜辛夏杏汤治疗的依据与优势。认为慢性阻塞性肺疾病是临床常见的严重危害人类健康、可防治疾病。临床表现除咳、痰、喘、满等肺气壅塞症状外,并发腹胀、便秘等胃肠功能障碍症状。慢性阻塞性肺疾病为本虚标实之证,日久各种病理产物可致肺肠气机壅滞,引起急性发作或伴发胃肠功能障碍。“气机壅滞”是慢阻肺急性发作(AECOPD)并发胃肠功能障碍的重要机制。

To summarize the theoretical basis for the treatment of chronic obstructive pulmonary disease(COPD)complicated with gastrointestinal dysfunction by“regulating Qi activity,reducing phlegm,and facilitating bowel movement”,and the basis and advantages of the application of Chailing Jiangqi Decoction,also called Dachaihu Decoction with Linggan Wuwei Jiangxin Xiaxing Decoction.It is believed that chronic obstructive pulmonary disease is a common,preventable and treatable disease that can seriously harm human’s health.In addition to the symptoms of choking lung gas such as cough,sputum,wheezing and fullness,its clinical manifestations are complicated with gastrointestinal dysfunction such as abdominal distension and constipation.COPD is the syndrome of primary deficiency,and various pathologic products can lead to pulmonary and intestinal Qi obstructing over time,causing acute attack or gastrointestinal dysfunction.“Qi movement stagnation”is an important mechanism of acute exacerbatio chronic obstructive pulmonary disease(AECOPD)complicated with gastrointestinal dysfunction.