范伏元教授从“络脉不和”论治肺结节经验

FAN Fuyuan's experience in treating pulmonary nodules based on the theory of"collateral disharmony"

范伏元教授基于络脉沟通内外、渗灌气血、联系脏腑的生理特点,从肺痹、肺积认识肺结节,以络脉不和为肺结节根本病机,从伏邪凝痰痹络、胃络不和痰瘀结为窠囊进行阐发,以“通络开痹,和荣散结”“和胃逐瘀,安神化浊”为核心治法,分别以疏风宣肺汤、加味温胆汤处方辨治,将宏观脏腑辨证调和诸脏与微观络脉辨证调和络脉营卫气血津液沟通渗灌相结合,临床疗效确切。

Collaterals can communicate interior with exterior and connect viscera,through which qi and blood permeate all parts of the body.Based on these physiological characteristics,Professor FAN Fuyuan understands pulmonary nodules from the perspectives of"lung impediment"and"lung accumulation".Collateral disharmony is considered as the fundamental pathogenesis of pulmonary nodules,which is further expounded in two aspects,namely the latent pathogenic qi resulting in phlegm and static blood which obstruct the lung collaterals,and disharmony of the stomach collaterals causing phlegm and static blood accumulating in the lungs to form Kenang(mass of phlegm mingled with static blood).Therefore,dredging collaterals to unblock impediment and harmonizing wei-defensive qi and ying-nutrient blood to dissipate nodules,as well as harmonizing the stomach and expelling stasis,calming the mind and transforming turbidity are taken as the core treatment methods.Shufeng Xuanfei Decoction and Jiawei Wendan Decoction are always prescribed respectively based on pattern differentiation.With their definite clinical efficacy,Professor FAN combines the macroscopic pattern differentiation of zang-fu organs which aims to reconcile the viscera with the microcosmic pattern differentiation of collaterals which aims to harmonize wei-defensive qi,ying-nutrient blood,and body fluids flowing in the collaterals.