肺结节病的中医证治探讨

Discussion on Syndrome and Treatment of Pulmonary Sarcoidosis with Traditional Chinese Medicine

从病因病机、辨证分型、中医治疗三个方面对肺结节病进行探讨,得出肺结节病病因主要有外感病因之六淫邪气和雾霾废气等秽浊之邪,内伤病因之情志失调、饮食所伤、劳逸所伤,病理产物病因之痰湿瘀毒为患,其他病因之先天禀赋失常及罹患其他慢性疾病;病机为肺脏虚损,病理产物阻之于肺,塞而不通,发为结节;辨证分型上外感型分风噪、风寒、风热、风湿、火热之不同,内伤型可有肝郁气滞、脾虚痰湿、肺气虚耗,病理产物型又有痰浊阻肺、痰瘀郁肺、痰瘀化毒之各异,他因型则分为阳虚证与气阴两虚证;治疗上提出五法论治和痰瘀论治,汗而发之以祛邪,清而解之通过泻、解、凉以除邪热,和而平之以调诸脏,和气血,下而除之以清里热、祛瘀血,虚而补之养气血阴阳、调虚弱,同时以化痰祛瘀解毒以通肺络;同时也提出中医疗养法治疗肺结节病,通过舒情志,畅气机,调和气血阴阳,培补正气以化结节,以期为肺结节病中医证治规范化略尽绵薄之力,为临床肺结节病治疗提供思路。

This paper discussed pulmonary sarcoidosis from etiology,pathogenesis,syndrome differentiation and treatment of traditional Chinese medicine.It is concluded that the main causes of pulmonary sarcoidosis are six exogenous pathogens and foul evils such as smog and waste gas,emotional imbalance of internal injuries,improper food and drink,improper work and rest,phlegm-dampness and blood stasis,congenital endowment disorder of other causes and suffering from other chronic diseases.The pathogenesis is lung deficiency,and pathological products are blocked in lung,resulting in nodules.The types of syndrome differentiation can be divided into wind-dry syndrome,wind-cold syndrome,wind-heat syndrome,wind-damp syndrome and fire-heat syndrome.Internal injury types include liver depression and Qi stagnation syndrome,spleen deficiency and phlegm-dampness syndrome and lung Qi deficiency and consumption syndrome.Pathological products can also be divided into phlegm-turbidity blocking lung,phlegm-blood stasis blocking lung and phlegm-blood stasis transforming toxin types.Other cause types can be divided into Yang deficiency syndrome and Qi-Yin deficiency syndrome.The five treatment methods are put forward,namely,eliminating pathogenic factors by sweating,eliminating pathogenic heat by purging,resolving and cooling,regulating Zang-organs and Qi and blood by harmonizing,clearing internal heat and removing blood stasis,nourishing Qi,blood,Yin and Yang,regulating weakness and dredging lung collaterals by resolving phlegm,removing blood stasis and detoxifying.At the same time,it also puts forward the TCM recuperation method to treat pulmonary sarcoidosis,by relaxing emotions,smoothing Qi,harmonizing Qi,blood,Yin and Yang,and nourishing vital Qi to eliminate nodules,so as to make a little contribution to the standardization of TCM syndrome differentiation and treatment of pulmonary sarcoidosis and provide ideas for clinical pulmonary sarcoidosis treatment.