从叶天士“初病在经,久病入络”理论论治肺纤维化

Treatment of Pulmonary Fibrosis from“Disease Progressively, Chronic Diseases Transforming to Collaterals”by Ye Tianshi

以叶天士"初病在经,久病入络"理论为基础,结合肺脏生理病理特点,阐明肺纤维化的病理机制具有病位由浅入深、病变由功能性到器质性的特点。病变初期多以气机失调、功能紊乱为主,表现为邪气入侵,肺络气机不利,治以宣气畅络;中后期病程日久,以肺虚不荣、血络瘀滞为主,表现为肺络痹阻,日久虚瘀互结,治以化瘀通补。故宣气畅络、化瘀通补为治疗肺纤维化的重要治法。从"初病在经,久病入络"理论论析肺纤维化疾病,能够很好的概括和阐述其疾病的发生发展演变过程,具有重要的临床指导意义。

Based on the theory of Ye Tianshi that ＂disease progressively, chronic diseases transforming to collaterals＂, physiological and pathological features of the lung were combined to elucidate the pathogenesis of pulmonary fibrosis, which had the characteristics of disease progressed from superficial location to deeper regions, and the disease transformed from functional to organic disease lesions. The initial stage was mainly qi disorders and dysfunction due to evil qi invasion and qi disorder in the lung collaterals. The treatment was to disperse qi and regulate collaterals. In the middle or later stage, the main pathogenesis was lung deficiency and blood stasis due to the obstruction of lung collaterals, as well as long-term mixture of deficiency and stasis. The treatment was to remove obstruction and tonify deficiency. Therefore, dispersing qi and regulating collaterals, as well as removing obstruction and tonifying deficiency were the main treatment methods of pulmonary fibrosis. Analysis on pulmonary fibrosis from the theory of ＂disease progressively, chronic diseases transforming to collaterals＂, can give a good summary and explanation of the disease occurrence, progress and development with important clinical significance.