尉敏廷从“虚、痰、瘀、毒”论治肺结节

YU Minting's Experience in Treating Pulmonary Nodules from“Deficiency,Phlegm,Blood Stasis and Toxin”

总结尉敏廷教授治疗肺结节的临床经验。认为肺结节发病之本在于肺脾肾虚,发病机制在于虚、痰、瘀、毒,围绕此四种因素,在临证治疗时,一者注重扶正固本,补益肺脾肾,擅用黄芪、红景天、党参、炒白术、菟丝子、女贞子等以养正除积散结;二者注重健脾助运,调补肺气,使气行而津行,擅用党参、炒白术、茯苓、砂仁、白豆蔻等健脾助运,黄芪、西洋参、山药、百合等补肺养阴,清半夏、茯苓、浙贝母、竹茹等清热化痰散结;三者强调久病由气及血、入络化瘀,擅用川芎、当归、芍药、路路通、莪术、丹参等化瘀通络散结,佐以全蝎、蜈蚣、水蛭、地龙等虫类药以搜剔通络消癥;四者注重治未病,谨防化毒生癌,擅用半枝莲、半边莲、白花蛇舌草、仙鹤草、金银花、连翘等以清热解毒散结。因此,基于虚、痰、瘀、毒四个方面及临证特色对药,对尉敏廷教授治疗肺结节进行总结,浅述其学术经验。

This article aims to summarize professor YU Minting's clinical experience in the treatment of pulmonary nodules.He believes that the origin of pulmonary nodules lies in deficiency of lung,spleen and kidney,and the pathogenesis lies in deficiency,phlegm,blood stasis and toxin.According to these four pathological factors,in the clinical treatment,firstly the treatment should pay attention to strengthening the root and tonifying lung,spleen and kidney,and make good use of Huangqi(Astragali Radix),Hongjingtian(Rhodiolae Crenulatae Radix Et Rhizoma),Dangshen(Codonopsis Radix),fired Baizhu(Atractylodis Macrocephalae Rhizoma),Tusizi(Cuscutae Semen)and Nyuzhenzi(Ligustri Lucidi Fructus)to nourish and eliminate accumulation and removing stasis.Secondly,the treatment should pay attention to invigorating spleen,regulating and replenishing lung Qi,so Qi and body fluid can flow normally,using Dangshen(Codonopsis Radix),fired Baizhu(Atractylodis Macrocephalae Rhizoma),Fuling(Poria),Sharen(Amomi Fructus)and Baidoukou(Amomi Fructus Rotundus)to strengthen spleen and help to transport,with Huangqi(Astragali Radix),Xiyangshen(Panacis Quinquefolii Radix),Shanyao(Dioscoreae Rhizoma)and Baihe(Lilii Bulbus)to replenish lung and nourish Yin,and Chuanxiong(Chuanxiong Rhizoma),Danggui(Angelicae Sinensis Radix),Shaoyao(Paeoniae Radix Alba),Lulutong(Liquidambaris Fructus),Ezhu(Curcumae Rhizoma)and Danshen(Salviae Miltiorrhizae Radix Et Rhizoma)to clear heat,dissolve phlegm and disperse the mass.Thirdly,it is convinced that the pathogenic factors of long-term illness are from Qi to blood and enter the collaterals to cause blood stasis.Chuanxiong(Chuanxiong Rhizoma),Danggui(Angelicae Sinensis Radix),Shaoyao(Paeoniae Radix Alba),Lulutong(Liquidambaris Fructus),Ezhu(Curcumae Rhizoma)and Danshen(Salviae Miltiorrhizae Radix Et Rhizoma)are used to remove blood stasis,clear collaterals and disperse the mass,accompanied by Quanxie(scorpion),Wugong(centipede),Shuizhi(leech)and Dilong(earthworm)to search and clear collaterals and eliminate the mass.Fourthly,it focuses on the prevention of disease and beware of toxin into tumor.Banzhilian(Scutellariae Barbatae Herba),Banbianlian(Lobeliae Chinensis Herba),Baihuasheshecao(Herba Hedyotidis Diffusae),Xianhecao(Agrimoniae Herba),Jinyinhua(Lonicerae Japonicae Flos)and Lianqiao(Forsythiae Fructus)are used to clear heat,detoxify and disperse the mass.Therefore,based on the four aspects of deficiency,phlegm,blood stasis and toxin and the characteristics of clinical syndromes,this paper summarized Professor YU Minting's academic experience in the treatment of pulmonary nodules.