从痰探讨肺间质纤维化的中医病因病机

Discussion of the Etiology and Pathogenesis of Pulmonary Interstitial Fibrosis in Terms of Phlegm in Traditional Chinese Medicine

针对肺间质纤维化慢性病程、逐渐加重的疾病特点,文章提出了痰邪致病的观点。详细论述了内伤痰邪的产生机制,认为肺、脾、肾、肝和三焦功能的失司,均可导致人体痰湿的产生。并参考现代医学的症状、体征和实验室检查,指出痰有显性表现和隐性指标,并提出个人的粗浅认识,凡是肺间质纤维化患者临床中出现咳嗽、咳痰、胸闷气短症状,或者是实验室检查出现血黏度、血脂、纤维蛋白原等指标升高,此时处方可从痰入手。最后将痰的致病特点总结为四个方面:起病缓慢,病情隐匿;病性复杂,兼夹他邪;痰分显隐,共同致病;危害严重,伤人形质。

Aiming at the characteristics of the chronic progression and gradual aggravation of pulmonary interstitial fibrosis, the paper put forward the view point that phlegm resulted in the disease. The paper discussed particularly the mechanism of the internal injury of phlegm and viewed that the dysfunction of the lung, spleen, kidney, liver and triple energize all led to the production of phlegm and damp in the human body. In reference to the symptoms, physical signs and laboratory examination of modem medicine, the paper pointed out the dominant manifestations and recessive indexes of phlegm as well as the personal basic understanding. When the patients with pulmonary interstitial fibrosis had cough, expectoration, chest oppression and short breathing in clinic, or the laboratory examination presented the level increases of blood viscosity, blood lipid, fibrinogen and the others, the prescription could be given based on phlegm. The pathogenic characteristics of phlegm were summarized as the following four aspects ： slow onset and hidden conditions, complicated nature and combination of the other pathogens, co - pathogenesis of dominant and recessive features of phlegm, and serious physical and metal hazards.