培土生金法在社区获得性肺炎治疗中的应用

Application of Banking up Earth to Generate Metal Method in Treatment of Community Acquired Pneumonia

培土生金法来源于五行学说,由《黄帝内经》提出,经过张仲景及金元四大家等医家的发展,至今其内涵实质已非常丰富。采用培土生金法治疗社区获得性肺炎(CAP)可获得良好疗效。在不同人群、不同疾病状态下,罹患CAP的患者可能会出现相同或不同的脾胃虚损的表现。轻者大多出现食少纳差、乏力倦怠等症状,可选用四君子汤或六君子汤加减以健脾益气。对于合并慢性疾病的老年CAP、重症CAP及耐药菌感染的CAP患者,脾胃气虚甚至阳虚的表现则更加明显,在健脾益气的基础上要重视温阳健脾,可选用黄芪、党参、附子、干姜等药物。儿童CAP的脾虚症状多由湿邪、热邪或食积所致,治疗时对症选用莲子、芡实、白扁豆、天花粉等药物。

The method of banking up earth to generate metal is derived from the theory of five elements,which was proposed in Inner Canon of Huangdi.After the development of ZHANG Zhongjing and the Four Great Physicians of the Jin and Yuan Dynasties,its connotation has been very rich.The method of banking up earth to generate metal is effective in the treatment of community acquired pneumonia(CAP).In different populations and different disease states,patients with CAP may show the same or different manifestations of spleen and stomach deficiency.In minor cases,most of the symptoms such as poor appetite,fatigue and tiredness,can select Sijunzi Decoction(四君子汤)or Liujunzi Decoction(六君子汤)to invigorate spleen and replenish qi.For elderly CAP patients with chronic diseases,severe CAP patients,and CAP patients with drug-resistant bacterial infection,the manifestations of qi deficiency and even yang deficiency of spleen and stomach are more obvious.On the basis of invigorating spleen and replenishing qi,we should pay more attention to warming yang and invigorating spleen,Chinese medicinals such as Huangqi(Astragali Radix),Dangshen(Codonopsis Radix),Fuzi(Aconti Lateralis Radix Praeparaia)and Ganjiang(Zingiberis Rhizoma),etc.,can be selected for the treatment.The symptoms of spleen deficiency in children with CAP are often caused by pathogenic dampness,pathogenic heat or food accumulation,which can be treated by using Chinese medicinals such as Lianzi(Nelumbinis Plumula),Qianshi(Euryales Semen),Baibiandou(Lablab Semen Album)and Tianhuafen(Trichosanthis Radix),etc.