王真教授治疗肺部结节的经验

Professor WANG Zhen’s Experience in Treating Pulmonary Nodules

[目的]总结王真教授治疗肺部结节的经验。[方法]通过临床跟师学习,分析研究王真教授治疗肺部结节的医案,总结王真教授治疗肺部结节的临床诊疗思路及方药特点,并举一验案加以佐证。[结果]王真教授认为肺部结节的发生与先天禀赋不足、情志调节失常、体质偏颇、空气环境恶劣等密切相关,瘀血是其发病的重要病理因素。对于中医治疗肺部结节,王真教授提出"症-证-体"结合的辨治模式:抓主症,对症治疗,辨证施治;辨体质,调整人体脏腑阴阳气血和机能代谢;重活血,化瘀消积;阅影像,配伍抗癌中药。所附验案中患者属肺脾阴虚、痰瘀互结之证,体质呈阴虚、血瘀、痰湿质,治以养阴健脾、化痰祛瘀之法,投以自拟方,取得明显疗效。[结论]王真教授治疗肺部结节注重"症-证-体"相结合,配用活血、抗癌药物,临床疗效显著,其经验对于肺部结节的中医药治疗有重要的借鉴意义。

[Objective]To summarize Professor WANG Zhen’s experience in the treatment of pulmonary nodules. [Methods]Through the clinical study with Professor WANG,the medical cases of Professor WANG’s treatment of pulmonary nodules were studied and analyzed,the clinical diagnosis and treatment ideas and prescription characteristics of Professor WANG in the treatment of pulmonary nodules were summarized,and a case was cited as evidence.[Results]Professor WANG believes that the occurrence of pulmonary nodules is closely related to congenital endowment deficiency,emotion regulation disorder,constitution bias,bad air environment and so on,and blood stasis is an important pathological factor.For the traditional Chinese medicine(TCM)treatment of pulmonary nodules,Professor WANG proposes the"symptom-syndrome-body"combined treatment model: Firstly,focus on the main clinical symptoms,symptomatic treatment,syndrome differentiation and treatment;secondly,distinguish the constitution,adjust the Yin and Yang,Qi and blood,and function metabolism of viscera;third,attach great importance to blood circulation,remove blood stasis and eliminate accumulation;last,read the chest imaging manifestations,compatibility of anti-cancer Chinese medicine.The case cited was differentiated as Yin deficiency of the lung and spleen and the mutual accumulation of phlegm and blood stasis,and the constitution was considered as Yin deficiency,blood stasis and phlegm dampness. The self-designed prescription was applied to nourish Yin and strengthen the spleen,dispel phlegm and blood stasis,and the obvious curative effect was achieved. [Conclusion]Professor WANG Zhen attaches great importance to the combination of "symptom-syndrome-body"in the treatment of pulmonary nodules,and supplemented with blood circulation invigorating and anti-cancer drugs.It has significant clinical effect,which has important reference significance for the treatment of pulmonary nodules with TCM.