特发性肺纤维化中医辨证治疗概要

General Situation of Idiopathic Pulmonary Fibrosis Treated by Chinese Medicine

特发性肺纤维化基本病机为正虚络痹积损,肺肾虚损为本,肺络痹阻、痰瘀互结为标;积损成痿、痹痿并存、虚实错杂为其特征。该病常见证候为虚证类(肺气虚证、阴虚内热证、肺肾气虚证)、实证类(痰热壅肺证、痰浊阻肺证)、兼证类(血瘀证)等三类六证候,以正虚为主而常兼实证,急性加重时则以实证类为主而常兼虚证。该病治疗以扶正祛邪为大法,体现于补、润、化、消。在制方用药时应注意:宣降、润肺以顺肺之生理,补益同时兼顾化痰、活血通络、消积散结,治之缓图,固护肺卫以防外邪袭肺而诱发加重。

The pathogenesis of idiopathic pulmonary fibrosis（ IPF） was the impediment disease connected by deficient healthy qi.The deficiency of the kidney and the lung was the inner cause of the disease and phlegm and blood stasis was the external cause of the disease. Its characteristic was that the increasing deficiency leads to atrophy-flaccidity disease,the coexistence of atrophyflaccidity disease and impediment disease,and the deficiency syndrome was mixed by excess syndrome. The common syndrome of this disease was deficiency syndrome（ the syndrome of deficient lung qi,the syndrome of deficient yin and internal heat,the syndrome of deficient lung qi and kidney qi）,excess syndrome（ syndrome of phlegm-heat obstructing lung,syndrome of turbid phlegm obstructing lung） and mixed syndrome（ syndrome of blood stasis） etc. It was based on deficient healthy qi accompanied by excess syndrome,and based on excess syndrome accompanied by deficiency syndrome when acute aggravated disease emerged. The treatment of this disease was by reinforcing the healthy qi and eliminating the pathogenic factors for method,which reflected in elimination,moistening,transferring and elimination. When making formula and using medicine,notice that：diffusing,ascending and moistening the lung to favor the physiologic character of lung;tonifying the lung and treated by resolving phlegm,activating blood,dredging collaterals,resolving accumulation and dissipating mass by mild formula; protecting lung-defense and preventing external pathogen attacking lung form developing disease.