从脾胃论治孤立性肺结节的中医诊疗经验

孤立性肺结节(Solitary Pulmonary Nodule)是指单一的、边界清楚的、影像不透明的、直径小于或等于30mm、周围为含气肺组织所包绕的病变,没有肺不张、肺门增大或胸腔积液表现的肺部结节。影像学表现为密度增高的阴影,可单发或多发,边界清晰或不清晰,有良恶性之分。西医的诊疗思路为定期复查,手术切除等,效果并不理想。吾师从中医角度辩证论治,从脾胃出发,以健脾化痰、温阳散寒、疏肝理气等为治疗原则,以改善患者的症状和体质为方向,治疗SPN,效果显著,现对临床治疗SPN的经验进行分析,以期促进同行临床交流,为临床治疗SPN提供思路。

Solitary Pulmonary Nodule refers to a single,well-defined,opaque,imaged lesion less than or equal to 30mm in diameter surrounded by aerated lung tissue,without manifestations of atelectasis,hilar enlargement,or pleural effusion.The imaging manifestation is the shadow of increased density,which can be single or multiple,the boundary is clear or unclear,and there are benign and malignant.Western medicine's diagnosis and treatment ideas are regular review,surgical excision,etc.,the effect is not ideal.My teacher dialectically treats SPN from the perspective of traditional Chinese medicine,starting from the spleen and stomach,taking invigorating the spleen and eliminating phlegm,warming Yang and dispelling cold,soothing the liver and regulating Qi as the treatment principles,and improving the symptoms and physique of patients as the direction to treat SPN,with remarkable effects.Now,the clinical treatment experience of SPN is analyzed,with a view to promoting clinical communication among colleagues and providing ideas for clinical treatment of SPN.