基于“肺与大肠相表里”理论和“整体观念”探讨慢性肺系病合并功能性便秘的诊治思路

Exploration of the Diagnosis and Treatment of Chronic Pulmonary Disease Complicated with Functional Constipation Based on the Theory of"Lung and Large Intestine Connected Externally and Internally"and"Overall Concept"

慢性肺系病和功能性便秘均是临床常见的难治性疾病,且易合并出现。对二者分别进行干预是现代医学的常规治疗模式,但疗效及安全性均不能令人满意。课题组在临床实践中发现,中医药治疗慢性肺系病合并功能性便秘具有独特的优势。笔者在中医“肺与大肠相表里”理论和“整体观念”指导下,提出慢性肺系疾病合并功能性便秘的病机涉及肺失宣肃致腑气不通、大肠传导失司致肺气上逆、脾失健运、肾精亏损、气血两虚、久病瘀滞等方面,治疗当以“肺肠合治”为总则,辅以健脾益肾、补气养血以扶本虚,行气化瘀以祛实邪,并据此整理临床常用方药,系统总结了本病的中医诊治思路。

Chronic pulmonary diseases and functional constipation are both common and refractory diseases in clinic,and are prone to co-occurrence.It is the most common treatment in modern medicine to intervene them separately,but the efficacy and safety are not satisfactory.In clinical practice,the research group found that traditional Chinese medicine has unique advantages in the treatment of chronic pulmonary diseases complicated with functional constipation.Under the guidance of the theory of"Lung and large intestine connected externally and internally"and the"Holistic concept",the author putted forward that the pathogenesis of the chronic pulmonary diseases complicated with functional constipation involves the loss of the dispersing and descending functions of the lung give rise to the stoppage of Fu-Qi,the loss of large intestine conduction to cause the adverse rising of lung Qi,dysfunction of spleen in transportation,insufficiency of kidney essence,deficiency of both Qi and blood,long-term illness and blood stasis.In the treatment,the general principle is to treat the lung and intestines together,supplemented by invigorating spleen and kidney,invigorating Qi and nourishing blood to support deficiency of the source,promoting Qi and removing blood stasis to eliminate evil.According to this,the common clinical prescriptions were sorted out,and the traditional Chinese medicine diagnosis and treatment ideas of this disease were systematically summarized.