论痰瘀关系在间质性肺疾病病机演变中的意义

Relationship between Phlegm and Blood Stasis in the Pathogenesis of Interstitial Lung Disease

间质性肺疾病(ILD)是一种以累及肺间质为主、以炎性病变和纤维化为特征的疾病,归属于中医学肺痹、肺痿范畴,而痰瘀贯穿了疾病的始终。津凝为痰,血滞为瘀,痰瘀可谓同源异物,两者相互转化、相互影响的特点直接影响ILD病机演变。本文论述了痰瘀相关理论、肺系疾病与痰瘀密切关系及其病机演变,并将其病机演变过程归纳为津停生痰、由痰及瘀、痰瘀互结三个阶段。临床可通过中医辨证结合现代西医诊断,对痰瘀关系进行辨证判读。体现在ILD治疗原则中,则为早期化痰为主,后期祛瘀为先,以期达到抑制病情进展、促使疾病向愈的目的。

Interstitial lung disease（ILD） refers to a disease involving the pulmonary interstitium characterized by fibrosis and inflammation,attributing to Feiwei or Feibi in TCM,with phlegm and blood stasis throughout the disease. Body fluids accumulate into phlegm,blood stagnates and transforms into blood stasis. Phlegm and blood stasis share the same origin. The mutual transforming and influencing characteristics affect the pathogenesis of ILD. This paper discussed the theory of phlegm and blood stasis,relationship between lung diseases and phlegm and blood stasis and summarized the pathogenesis of interstitial lung disease as three stages,including body fluids accumulating into phlegm,phlegm leading to blood stasis and interacting be- tween each other. The relationship between phlegm and blood stasis can be diagnosed by western medicine and syndrome differentiation. ILD should be treated by eliminating phlegm in the early stage and dispelling blood stasis in the later stage in order to inhibit disease progression and promote healing.