中医药临床优势病种探讨——肺结节

Expert Consensus on Clinical Diseases Responding Specifically to Traditional Chinese Medicine:Pulmonary Nodules

近年来,肺结节的发病率逐年上升,为充分发挥中医药在肺结节领域的疗效优势,明确中西医结合切入点,进一步规范肺结节临床诊疗,中华中医药学会组织中、西医专家围绕肺结节的现代医学认识进展、中医病因病机治法各家学说、中医药参与肺结节全程管理的作用与优势、肺结节科学研究的内容与方法及肺结节科普工作等进行深入探讨,为临床诊疗实践和科学研究提供参考依据和有益借鉴。与会专家讨论后认为,肺结节的病因多考虑为虚实夹杂,虚证责之肺脾,实证多为痰湿、血瘀、气滞。中医药治疗肺结节作用包括对部分患者局部结节的控制、缩小;对体质的改善;对多系统结节性疾病的改善;减少焦虑情绪及过度诊断治疗;作为不愿意、不适合接受手术治疗患者的替代方案。目前,肺结节最佳诊疗策略尚未形成,需要从临床流行病学、生物学和循证医学等不同角度深入探讨研究。找到中医药干预肺结节的优势环节、有效方药、明确目标人群和确定有效结局是目前研究的首要任务,同时应积极开展基础研究,对肺结节病因、生物学行为进行深入探讨。中西医结合肺癌诊疗专家共识需不断修订完善,指导临床医生规范、科学、精准地进行有效诊疗管理。

In recent years,the incidence of pulmonary nodules has kept rising.To give full play to the advantages of traditional Chinese medicine(TCM)in the treatment of pulmonary nodules and identify the breakthrough points of integrating TCM with Western medicine,the China Association of Chinese Medicine organized medical experts in TCM and western medicine to carry out in-depth discussion regarding this disease.The discussion encompassed the modern medical advances,TCM theories of etiology and pathogenesis,the role and advantages of TCM in the whole course management of pulmonary nodules,contents and methods of research on pulmonary nodules,and science popularization work,aiming to provide a reference for clinical practice and scientific research.After discussion,the experts concluded that the occurrence of pulmonary nodules was rooted in the deficiency of the lung and spleen and triggered by phlegm dampness,blood stasis,and Qi stagnation.TCM can treat pulmonary nodules by controlling and reducing nodules,improving physical constitution,ameliorating multi-system nodular diseases,reducing anxiety and avoiding excessive diagnosis and treatment,and serving as an alternative for patients who are unwilling or unfit for surgical treatment.At present,the optimal diagnosis and treatment strategy for pulmonary nodules has not been formed,which needs to be further studied from multiple perspectives such as clinical epidemiology,biology,and evidence-based medicine.The primary task of current research is to find out the advantages,effective prescriptions,and target populations and determine the effective outcomes of TCM in the treatment of pulmonary nodules.At the same time,basic research should be carried out to explore the etiology and biological behaviors of pulmonary nodules.The expert consensus on the diagnosis and treatment of pulmonary nodules with integrated TCM and Western medicine needs to be continuously revised to guide clinicians to conduct standardized,scientific,and accurate effective diagnosis and treatment.