从湿、热、虚论治特发性炎症性肌病所致肺间质疾病

Treatment of idiopathic inflammatory myopathy with interstitial lung disease by eliminating dampness, heat and reinforcing deficiency

特发性炎症性肌病(IIM)可累及肺脏,表现为间质性肺疾病(ILD),导致患者病死率升高,明显降低患者的生活质量。本病西药治疗方案以激素联合免疫抑制剂为主,短期有效率为50%左右,在治疗过程中易复发,远期结局不明确。本类疾病临床表现复杂,中医学可见散在论述,但缺乏系统性研究。本科通过队列研究初步明确了其基本证型,归纳出湿、热、虚等致病因素在IIM-ILD的发病起重要作用,确立了清热凉血、化湿解毒、通畅三焦、益气补中的基本治则。

Idiopathic inflammatory myopathy(IIM)can involve the lung,presenting as interstitial lung disease(ILD),leading to increased mortality and quality of life of patients.Western medicine treatment is mainly based on hormone combined with immunosuppressive agents.The short-term effective rate is about 50%.It is easy to relapse in the course of treatment and the long-term outcome is not clear.The clinical manifestations of the disease are complex and lacking systematic research in TCM.Our department identified the basic syndromes,summed up that the dampness,heat,and deficiency played an important role in the pathogenesis of IIM-ILD,established the basic rule of removing pathogenic heat from the blood,humidification,and detoxification,clearness of sanjiao and reinforcing qi.