支气管扩张症的全程管理及中医诊治思路探讨

Discussion on Overall Management and the Diagnosis and Treatment Process of Bronchiectasia in Chinese Medicine

支气管扩张症是难治的结构性肺病,细菌定植、黏液高分泌状态、气流受限导致支扩反复急性加重、频繁住院等临床问题,严重影响患者的肺功能及生活质量。在临床工作中要提高对支气管扩张症病因的认识,尤其一些特殊病因导致的支气管扩张症,针对病因确定治疗方案可极大地改善患者预后。中医强调补脾清肺,从提高患者免疫功能入手,控制细菌定植;发挥中医化痰优势,改善患者气道黏液高分泌状态;针对伴有气流受限的患者治以宣肺降气,纳气平喘。

Bronchiectasia is a kind of structural pulmonary disease. Factors of bacteria colonization,state of mucus hypersecretory and airway limitation lead to clinical problems such as repeat and aggravation of bronchiectasia and frequently hospitalization,seriously influencing pulmonary function and quality of life of the patients. The recognition of the etiology of bronchiectasia should be improved in clinical practice,especially when it is caused by special etiology. Treatment on syndrome differentiation can significantly improve the prognosis of the patients. In the theory of traditional Chinese medicine,invigorating spleen for clearing lung is stressed to improve the function of immune system,and make the bacteria colonization under control. Dissolving phlegm is taken full advantages to improve the state of mucus hypersecretory in patients＇ airway. Methods like diffusing the lung and directing qi downward,improving qi reception and relieving panting are used on patients accompanying with airway limitations.