基于玄府气液理论探讨系统性硬化症相关间质性肺疾病病机及临床诊治

Mechanism and Clinical Diagnosis of Systemic Sclerosis Related Interstitial Lung Disease Based on the Xuanfu Qi-liquid Theory

系统性硬化症相关间质性肺疾病在中医角度属于“肺痹”“肺痿”等范畴,阳虚血瘀是其基本病机。玄府是气液流通的最基本通道,认为玄府气液理论贯穿系统性硬化症相关间质性肺疾病病机演变的全过程。该文阐述了营卫失调,卫阳亏虚,皮毛玄府不固为始动因素;玄府开阖失司,肺脾不足,络脉闭阻以致气液不化是其进展原因;元阳虚衰,诸脏痿废,神失所用为其终末危象。论述了基于玄府气液理论,在温阳通玄、通补启玄、化瘀通玄、敷刺透玄基础上,活用风药对系统性硬化症相关间质性肺疾病临床遣方的重要意义。

Systemic sclerosis related interstitial lung diseases are often ascribed to the categories of“pulmonary arthralgia”“pulmonary collapse”in the TCM perspective,and Yang deficiency and blood stasis are the basic disease mechanisms.Xuanfu is the most basic channel for Qi-liquid circulation,and it is believed that the whole process of Xuanfu Qi-liquid theory extends through the evolution of systemic sclerosis related interstitial lung diseases mechanisms.This article explicated on the imbalance between Ying and Wei,the deficiency of Weiyang,and the instability of Xuanfu fur as the initiating factors;Xuanfu opening and closing loss of control,deficiency of lung and spleen,blockage of collaterals so that Qi-liquid does not work as the causes of its progression;The deficiency and decline of Yuanyang,the withering and decline of various organs,and the loss of energy and function as the ultimate crisis.Based on the Xuanfu Qi-liquid theory,on the basis of warming Yang and smoothing Xuan,purgation-tonifying and initiating Xuan,removing stasis and smoothing Xuan,pasting acupuncture and penetrating Xuan,the important significance of using wind medicine to treat systemic sclerosis related interstitial lung diseases in clinical practice.