从瘀毒角度运用治未病思想防治肺结节

Using Concept of “Treating Disease Before It Arises” in Prevention and Treatment of Pulmonary Nodules from Perspective of Stasis and Toxin

肺结节是指肺内出现的不规则病灶,影像学表现为高密度阴影。基于中医学对瘀、毒的认识,以及肺结节的临床表现,对肺结节的防治进行探讨,分析认为瘀、毒既可以是肺结节的病理产物,也可以是致病因素,且贯穿疾病的始终。肺结节疾病发展可分为三个阶段,第一阶段是邪犯肺脏,积聚成瘀;第二阶段是邪毒炽盛,痹阻肺络;第三阶段是正气亏虚,瘀毒搏结。因部分肺结节可发展为早期肺癌病变,鉴于疾病转归的特殊性,提出运用中医治未病思想防治肺结节,可根据瘀、毒作用的强弱、时间节点及位置,结合肺结节证候演变的全过程,抓住存在的时间节点,判定结节的性质,确立治则治法,针对性控制病情,防止传变。

Pulmonary nodules are irregular lesions that appear in the lungs with high-density shadows on the imaging.Based on the understanding of stasis and toxin in Chinese medicine,as well as the clinical manifestations of pulmonary nodules,the prevention and treatment of pulmonary nodules are discussed.Analysis shows that stasis and toxin can be pathological products and pathogenic factors of pulmonary nodules,and run through the entire course of the disease.The development of pulmonary nodules can be divided into three stages;the first stage is the pathogen invading the lung and accumulating into stasis;the second stage is the exuberance of pathogenic toxin and the impediment obstructing the lung collateral;the third stage is the deficiency of healthy qi and the stagnation of stasis and toxin.Because some pulmonary nodules can develop into early lung cancer lesions,in view of the specificity of the disease outcome,it is proposed to use the concept of“treating disease before it arises”in Chinese medicine to prevent and treat pulmonary nodules,which is,according to the severity,time nodes,and location of stasis and toxin,and with the combination of the entire process of the development of pulmonary nodules syndromes,we can seize the existing time nodes,determine the nature of the nodules,establish treatment principles and methods,take targeted control measures of the disease,and prevent transmission and development.