论肺痿与支气管扩张

Discussion on Fei Wei and Bronchiectasis

"肺痿"病名首见于《金匮要略》,以咳吐浊唾涎沫为主症。近年来部分学者认为肺纤维化与肺痿相对应,然而二者表现不尽相同。考证自汉以降中医文献,所载肺痿症状并不一致。仲景记述肺痿以咳吐浊唾涎沫为主要表现,与支气管扩张最为相近。仲景之后,随着疾病谱改变,医家言及肺痿,所述症状除浊唾涎沫外,尚有咯血、咳脓痰等,对应疾病与仲景所指则有所拓展,除支气管扩张外还包括肺结核、肺脓肿等。中医病名所指疾患随时代变迁多有不同,"肺痿"一病不同时期所对疾病亦不尽相同。

Fei Wei,mainly manifested as sputum and expectoration,was firstly found in Synopsis of Prescriptions of the Golden Chamber. In recent years,some of the scholars consider Fei Wei equals to pulmonary fibrosis. As a matter of fact,the two are different in clinical manifestation. We reviewed all the literatures of traditional Chinese medicine since Han dynasty and found the symptoms of Fei Wei described in the literatures were different. The one ZHANG Zhongjing described was symbolized as sputum and expectoration,which was similar to bronchiectasis. After Zhongjing,as the disease spectrum was changed gradually,the descriptions of Fei Wei added symptoms such as hemoptysis and vomica,and these were the symptoms of bronchiectasis,tuberculosis and pulmonary abscess. Fei Wei,as other disease names in traditional Chinese medicine,was representing different diseases in different history periods.