范永升诊治系统性红斑狼疮相关间质性肺疾病经验总结

FAN Yong-sheng's experience in the diagnosis and treatment of interstitial lung disease in systemic lupus erythematosus

范永升教授认为热毒内蕴是系统性红斑狼疮发生间质性肺疾病的基本病机,同时存在热毒伤阴及痰浊、瘀血等病理因素,后期又见气阴两虚或阴阳两虚之证候。临床辨证可分为虚实两端,实证以热毒蕴肺和燥热伤肺为主要证型,虚证以气阴两虚、阴阳两虚为主要证型。治疗原则为实则泻之、虚则补之。实证以清热润燥、宣肃肺气为主,虚证以益气养阴、温阳润肺为主。临床论治时要及时祛除外邪、不忘祛除痰瘀等病理产物、时刻注意保护津液和重视调理肺脾肾。文章列举验案2例,以飨同道。

Professor FAN Yong-sheng believes that internal amassment of heat-toxicity is the basic pathogenesis of interstitial lung disease in systemic lupus erythematosus（SLE）, and yin injured by heat-toxicity, turbid phlegm, static blood and others are also the pathological factors. At the later stage of the disease, syndrome of deficiency of both qi and yin or syndrome of deficiency of both yin and yang can be seen. The clinical syndrome differentiation can be divided into deficiency and excess. The main syndrome types of excess syndrome are syndrome of heat-toxicity blocking lung and syndrome of dryness-heat injuring lung. The main syndrome types of deficiency syndrome are syndrome of deficiency of both qi and yin and syndrome of deficiency of both yin and yang. The treatment principle is treating excess syndrome with purgative methods and treating deficiency syndrome with tonifying methods. Treating excess syndrome is mainly by clearing heat and moistening dryness, dispersive and descending lung qi. Treating deficiency syndrome is mainly by benefiting qi and nourishing yin, warming yang and moistening lung. Essentials of clinical treatments include getting rid of external evils in time, not forgetting to get rid of phlegm, blood-stasis and other pathological products, always paying attention to protecting fluid and regulating lung, spleen and kidney. And two experienced cases were listed for the benefit of peers.