基于辛温通络散结法探究肺结节的临床辨治模式

Exploring the diagnosis and treatment mode of pulmonary nodules based on the method of unblocking collaterals and dissipating masses with acrid-warm medicinals

肺结节是指影像学表现为直径≤3 cm的局灶性、类圆形、密度增高的实性或亚实性肺部阴影,常为肺癌的早期病变。气滞、津停、络郁是肺结节的核心病机,气、痰、瘀为肺结节的主要病理因素,外邪犯肺或情志不舒是肺结节的主要病因,肺络是肺结节的基本病位。临床施治以辛温通络散结为治疗大法,选用辛散温通、引经透络的药物,以射干麻黄汤为代表方,并随证加减变化,可提高临床疗效。

Pulmonary nodules are focal,round-like,solid,or sub-solid radiographic opacities that measures up to 3 cm.Pulmonary nodules can turn out to be cancerous.TCM theories believe that the basic pathogenesis of the condition is stagnation of lung qi,stasis of body fluids,and blockages of collaterals.In this framework,qi,phlegm,and stasis are the key pathological factors,and the main causes of pulmonary nodules are exogenous pathogens attacking the lungs or emotional discomfort,damaging the lung collaterals,the main location of the disease.In clinical practice,the basic method is unblocking collaterals and dissipating masses with acrid-warm medicinals.Shegan Mahuang Decoction is selected as the representative formula and adjusted as needed for different syndromes,to improve the clinical efficacy.