蔡宛如教授“脏腑同治法”辨治慢性阻塞性肺疾病经验拾掇

Professor CAI Wanru's Experience of "Zang and Fu with Treatment Together" in Treating Chronic Obstructive Pulmonary Disease

[目的]总结蔡宛如教授"脏腑同治"辨治慢性阻塞性肺疾病的经验。[方法]分析蔡宛如教授对脏腑同治理论辨治慢性阻塞性肺疾病的认识,阐述其独到的临证思维及用药经验,并附经典案例以验证。[结果]蔡宛如教授认为"五脏六腑皆令人咳,非独肺也",指出五脏六腑受累均可致肺系疾病发生,而慢性阻塞性肺疾病病程长,病因病机错杂,常非肺系一脉所为病,更需有五脏六腑相为病的整体观念。脏腑同治法主要体现在肺胃同治、肺与大肠同治、肺与三焦同治,如治上焦咳嗽,不单治肺,而应治在心肺;治疗缓解期患者,不可一味过补,还应清泄余邪。认为"治气"与"治痰饮"是治疗慢性阻塞性肺疾病两个关键点等,并将此验之以临床。所述医案从肺、心、肾、大肠等脏腑论治,气血水饮同治,获得佳效。[结论]蔡宛如教授"脏腑同治"理论治疗慢性阻塞性肺疾病,对指导临床治疗有实用价值,值得继承推广。

[Objective]To sumup Professor CAI Wanru＇s experience of ＂Zang and Fu with treatment together＂ in treating chronic obstructive pulmonary disease. [Methods]To analyze the understanding of CAI Wanru＇s theory of ＂Zang and Fu with treatment together＂and treatment of chronic obstructive pulmonary disease.Elaboration of her unique clinical thinking and medication experience, it is pointed out the application of Zang Fu Tongzhi method in clinical practice. To attach the classic case to verify. [Results] Professor CAI thinks ＂the viscera are causing cough, not only lung＂.The viscera involvement occurred can cause lung disease. The duration of chronic obstructive pulmonary disease is long, and its etiology and pathogenesis are complex, not only lung disease.It is better to be ＂Zang and Fu with treatment together＂. She thinks that the treatment of ＂Zang and Fu with treatment together＂ is mainly reflected in the treatment of lung and stomach, the treatment of lung and colon, the treatment of lung and triple burner. And be innovative in the previous basis, such as treating upper-Jiao cough, not only cure the lung, but should be ruled in the heart and lung; Patients with remission during treatment should not blindly oversupply, but also should clear up the remaining evil; That ＂gas treatment＂ and ＂cure phlegm＂ is the treatment of chronic obstructive pulmonary disease are two key points. Professor CAI has been innovating on the basis of her predecessors, flexible use of drugs, the example medical case, from the blood and phlegm treatment, often gets good clinical efficacy. [Conclusion] Professor CAI Wanru＇s theory of ＂Zang and Fu with treatment together＂ has good clinical application value, and it is worthy of being promoted.