综述益气化痰活血法治疗慢性阻塞性肺疾病稳定期研究新进展

A review on the method of supplementing Qi,resolving phlegm,and activating blood circulation in the treatment of stable stage of COPD

慢性阻塞性肺疾病是临床中具有高发病率的呼吸内科疾病,以气流阻塞为主要临床表现,好发于春冬交替时期。随着患者的自身免疫功能逐步减弱,加之营养不良等因素影响,可导致其体质量下降,引发肌肉萎缩、呼吸衰竭等症状。抗感染、维持电解质平衡、解痉平喘等是临床常规治疗方式,但由于近年来抗生素滥用现象突出,极易引发致病菌耐药,单纯抗炎抗菌干预已难以取得理想效果。中医在治疗肺部疾病方面累积了一定经验,慢性阻塞性肺疾病与中医学中的咳嗽、肺胀、喘证较为相近,痰浊与瘀血并见,促使气道堵塞,气机失常,水液无法气化而生成痰湿。中西医有效联合有利于体现独特的治疗优势。慢性阻塞性肺疾病稳定期是强化疗效的关键阶段,在此阶段以气虚为基础核心,痰瘀内盛为关键,中医学中主张将益气化痰祛瘀通络作为干预原则,认为益气化痰活血法是改善慢性阻塞性肺疾病稳定期的主要方式,在西医基础上联合益气化痰活血法干预有助于改善临床症状,达到固本护元的作用。为了探讨益气化痰活血法的应用价值,本研究采用文献查证法,针对慢性阻塞性肺疾病稳定期的基本病机进行分析,重点探究益气化痰活血法的治法核心以及其在慢性阻塞性肺疾病稳定期中的应用疗效,旨在为中医治疗慢性阻塞性肺疾病稳定期提供参考依据。

Chronic obstructive pulmonary disease is a respiratory disease with high incidence rate in clinic.The main clinical manifestation is airflow obstruction,which usually occurs in the alternating period of spring and winter.With the gradual weakening of patients'autoimmune function,and the influence of malnutrition and other factors,it can lead to the decline of the body mass and symptoms such as muscle atrophy and respiratory failure.Anti-infection,maintaining electrolyte balance,antispasmodic and antiasthmatic are routine clinical treatment methods.However,due to the prominent abuse of antibiotics in recent years,it is very easy to cause pathogenic bacteria resistance.Simple anti-inflammatory and antibacterial intervention has been difficult to achieve ideal results.Traditional Chinese medicine has accumulated some experience in the treatment of lung diseases.Chronic obstructive pulmonary disease is relatively similar to the cough,pulmonary distention and asthma syndrome in traditional Chinese medicine.Phlegm turbidity and blood stasis are seen at the same time,which promotes airway blockage,abnormal Qi(气)movement,and abnormal gasification of water and liquid,resulting in phlegm and dampness.The effective combination of TCM and Western medicine is conducive to reflect the unique therapeutic advantages.The stable stage of chronic obstructive pulmonary disease is the key stage to strengthen the curative effect.In this stage,Qi deficiency is the core,and phlegm and blood stasis is the key.Traditional Chinese medicine advocates supplementing Qi,resolving phlegm,removing blood stasis and dredging collaterals as the intervention principle.It is considered that the method of supplementing Qi,resolving phlegm and activating blood circulation is the main way to ameliorate the stable stage of chronic obstructive pulmonary disease.On the basis of Western medicine,the intervention of supplementing Qi,resolving phlegm and activating blood circulation is helpful to relieve clinical symptoms and achieve the role of consolidating the foundation and protecting the essence.In order to explore the application value of the supplementing Qi,resolving phlegm and activating blood circulation method,this study uses the literature verification method to analyze the basic pathogenesis of chronic obstructive pulmonary disease,focusing on the core of the supplementing Qi,resolving phlegm and activating blood circulation method and its application effect in the stable period of chronic obstructive pulmonary disease,in order to provide reference basis for the treatment of stable period of chronic obstructive pulmonary disease in TCM.