过敏性支气管肺曲霉病中医病因病机探讨

Discussion on the TCM pathogen and pathogenesis of ABPA

过敏性支气管肺曲霉病,其致病因素分为外因和内因。外因多为外感疫毒,内因为肺虚。病机为外邪引动伏痰,痰气搏结,发为"哮病""喘病"。随着疾病的发展,痰与热结,蕴结于肺,继而造成肺脾肾气阴两伤,虚火上炎,发为咳嗽、咯血、脓臭痰等一系列支气管扩张表现。在疾病晚期,由气及血,肺脾肾进一步受损,阴阳两虚,气血不充,失于濡养,进一步表现为"肺胀""肺痿"。病理因素主要为"虚""痰""瘀",三者互为因果,加重疾病的进展。其病位在肺,后累及脾、肾。

Allergic bronchopulmonary aspergillosis （ABPA） is a sort of inflammatory. From the perspective of traditional Chi- nese medicine, it belongs to the categories of asthma, suppurative lung disease, pulmonary flaccidity and pulmonary arthral- gia. The pathogens consist of two aspects, the internal cause and the external cause. The external is exogenous toxin and deft- ciency, and the internal is lung deficiency. In the early phase of the disease, external cause arises latent sputum, which re- suits in the combination of sputum and Qi therefore resulting in asthma. With the progression of ABPA, sputum combines with heat, which causes injury of Qi and Yin as well as flaring up of deficiency fire. Those led to the symptoms of bronchiec- tasis, such as cough, hemoptysis and foul-smelling sputum. In the later phase of the disease, more severe depletions of lung, spleen and kidney result in deficiency of Yin and Yang, thus the symptoms of pulmonary flaccidity and pulmonary arthralgia appear. The pathological factors are deficiency, phlegm and blood stagnation. They interact with each other and lead to further exacerbation. The pathological region initially locates at lung and then comes to spleen and kidney.