汪再舫治疗慢性阻塞性肺疾病经验

Wang Zai-fang′s Experience of Treating Chronic Obstructive Pulmonary Disease

汪再舫主任中医师治疗缓解期慢性阻塞性肺疾病(简称慢阻肺)时,强调把慢阻肺的分级和中医辨证相结合。慢阻肺缓解期以肺脾肾三脏亏虚,痰、瘀、气滞作为内源性致病因素,贯穿于疾病发生、发展的整个过程。汪老师认为,该病缓解期往往表现为虚多实少,虚中夹实,应根据每位患者的不同体质,不同临床表现,进行详细辨证。汪老师认为,慢阻肺初期应补肺固表,化痰止咳,方选玉屏风散合补肺汤加减。慢阻肺进展期宜补益肺脾,化痰止咳,方选玉屏风散合四君子汤、苓桂术甘汤。随着病情进展,累及肺肾时,则应补肺纳肾,降气平喘,方选生脉散合皱肺汤、人参蛤蚧散。肺脾肾三脏俱虚者,需补肺健脾益肾纳气,化痰止咳平喘,方选参蛤散、异功散、金匮肾气丸。

In terms of treating chronic obstructive pulmonary disease(COPD),Wang Zai-fang,a TCM chief physician,stresses that the classification of COPD should be combined with TCM syndrome differentiation.In the remission period of COPD,deficiency of the lung,spleen and kidney,phlegm,blood stasis and qi stagnation are the endogenous pathogenic factors,which run through the whole process of the occurrence and development of the disease.Professor Wang believes that the disease in the remission period is often manifested as more deficiency and less excess,with deficiency mixed with excess,which should be differentiated in detail according to the different constitution and clinical manifestations of each patient.In the early stage of COPD,the treatment should focus on nourishing the lung and strengthening the surface,dissipating phlegm and stopping cough.Jade Wind-Barrier Powder combined with Modified Lung-Supplementing Decoction can be used.In the progressive stage,it is better to invigorate the lung and spleen,dissipate phlegm and stop cough.Jade Wind-Barrier Powder combined with Four Gentlemen Decoction,and Poria and Cinnamon Twig and Atractylodes Macrocephala and Licorice Decoction can be used.With the progress of the disease,when the lung and kidney are involved,it is necessary to supplement the lung and the kidney,lower qi and relieve asthma.Pulse-Engendering Powder combined with Lung-Wrinkle Decoction,and Ginseng and Gecko Powder can be used.For those with deficiency of the lung,spleen and kidney,it is necessary to invigorate the lung,strengthen the spleen,nourish the kidney and absorb qi,dissipate phlegm,relieve cough and asthma,Ginseng and Gecko Powder,Special Achievement Powder,and Golden Cabinet′s Kidney Qi Pill can be used.