从肝论治特发性肺纤维化

Treating Idiopathic Pulmonary Fibrosis from the Liver

肺和肝两经首尾相连,使十二经脉阴阳相贯,且肝经可注入肺;肺与肝阴阳相配,一为阴中之少阳,一为阳中之少阴,是人体阴阳变化之枢纽;金木制化,肺金宣肃有序,肝木疏泄有度,紧密配合;肺与肝司气机升降,肝升肺降,肝左肺右,一升一降,升降协调,为调畅气机的枢纽;肺与肝主调和气血,肝主藏血,肺主一身之气。肝失疏泄,势必影响调畅气机和调节血量,气血失和,肺失治节,肺叶失于濡养,日久形成特发性肺纤维化;肺与肝调津液代谢,肺为水之上源,主通调水道,肝主疏泄,畅达气机,通利三焦,气能行津,维持机体津液正常代谢。肝失疏泄,影响肺金通调水道,则水液停聚和津液不足,肺津失布,肺叶痿废,发为特发性肺纤维化。由此提出,把从肝论治作为治疗肺纤维化的原则,拟定疏肝理肺,养肝润肺,清肝利肺大法。

The lung meridian is connected with the liver meridian from head to tail,making the Yin and Yang of the twelve meridians connect,and the liver meridian can be injected into the lungs.The Lung and the liver belong to the combination of Yin and Yang.One is the Shaoyang in Yin,the other is the Shaoyin in Yang,which is the pivot of the change of Yin and Yang in human body.The lung jin diffuses and descends orderly.The conveyance and dispersion of liver mu is moderate.They cooperate closely with each other.The liver and the lungs are in charge of ascending and descending of qi.The liver qi is ascending,while the lung qi is descending.The liver is on the left,while the lung is on the right.One ascends and the other descends.Coordination of ascending and descending is the pivot of regulating qi.The Lung and the liver harmonize qi and blood.The liver is in charge of storing blood.The lungs are in charge of qi.If the liver loses its function of conveyance and dispersion,it will inevitably affect the regulating qi and blood volume.Idiopathic pulmonary fibrosis occurs over time due to the disharmony between qi and blood,the loss of management and regulation of the lungs,the lungs being not nourished.The Lung and the liver regulate the metabolism of body fluid.The Lung is the source of water and has the function of regulating water channel.The Liver controlls conveyance and dispersion,which has the functions of expediting qi and clearing Sanjiao.Qi can regulate body fluid and maintain normal metabolism of body fluid.If the liver loses its function of conveyance and dispersion,it will affect the lungs function of regulating water passage.then the water will stop gathering and the body fluid will be insufficient.Idiopathic pulmonary fibrosis is caused by loss of proliferation of lung fluid and impotence of lung lobes.It is suggested that the treatment of pulmonary fibrosis should be based on the theory of liver,and that the methods of dispersing stagnated liver qi and regulating lung,nourishing the liver and moistening the lung,clearing liver-fire and disinhibiting the lung should be formulated.