二十四节气理论在慢性阻塞性肺疾病慢病管理中的应用

Application of twenty-four solar terms therapy in chronic disease management of chronic obstructive pulmonary disease

慢性阻塞性肺疾病与五脏相关,急性加重与气候有明确相关性。结合六气理论,二十四节气可分为六个阶段。初之气,厥阴风木之时,在人体以肝气变化明显,应加强调理肝肺的气机。二之气,少阴君火之时,心气渐旺,进展至肺心病的患者要加强养心。三之气,少阳相火之时,暑湿蕴蒸,慢性阻塞性肺疾病患者容易感受暑湿之邪,此时需加强清热祛湿。四之气,太阴湿土之时,湿邪困脾,肺脾两虚的患者可辨证养脾。五之气,阳明燥金之时,以肺燥表现为主,可加强清肺润燥。六之气,太阳寒水之时,肾气收藏,肺肾两虚的患者可辨证调养。通过医药和日常调养相结合的慢病管理方式,达到改善慢性阻塞性肺疾病患者生活质量和生存预后的目的。

Chronic obstructive pulmonary disease has relationship with five zang viscera, and acute exacerbation is clearly relevant to climates. According to the theory of six climatic factors, the twenty-four solar terms can be divided into six stages. During the first stage, the time of wind wood of jueyin, the patients can be easily affected by the over uprising of liver qi, so it is necessary to strengthen the regulation of qi movement of liver and lung. While in the second stage, the time of sovereign fire of shaoyin, the heart qi is getting hotter, the patients who have developed into pulmonary heart disease should strengthen the therapy of nourishing heart. In the third stage, the time of shaoyang assistant fire, summerheat dampness is striking, and the patients with chronic obstructive pulmonary disease are easily attacked by summerheat dampness, thus it is necessary to strengthen the therapy of clearing heat and eliminating dampness. In the fourth stage, the time of wet earth of taiyin, the spleen was disturbed by dampness pathogen, the patients with deficiency of both lung and spleen should nourish spleen based on syndrome differentiation. In the fifth stage, the time of dry gold of yangming, the main manifestation is lung dryness, so it is necessary to strengthen the therapy of clearing lung-heat and moistening dryness. In the sixth stage, the time of cold water of taiyang, the kidney begins to accumulate the needed essence, the patients with deficiency of both lung and kidney can invigorate lung and kidney based on syndrome differentiation. The chronic management of combining medicine and daily aftercare can achieve the purpose of improving the quality of life and prognosis of patients with chronic obstructive pulmonary disease.