从伏邪论治机化性肺炎合并吸烟相关性间质性肺疾病医案

Treatment of Organizing Pneumonia Complicated with Smoking-Related Interstitial Lung Disease from the Theory of Latent Pathogen:Report of One Case

机化性肺炎(OP)是指肺泡腔、肺泡管或伴有细支气管管内肉芽组织栓形成为病理特征的非特异性炎症。其大部分病因不明,无特征表现,影像具有游走的特点,若合并吸烟相关性间质性肺疾病(SR-ILD),极易漏诊误诊。因其具有起病隐匿潜藏、遇感而发、病程缠绵、反复发作、难以治愈等特点,与伏邪极为相似,中医多将其归为“肺痿”“肺痹”等范畴。本文通过1例OP合并吸烟相关性间质性肺疾病的临床案例分析,从伏邪理论角度辨治,为治疗OP提供临床诊疗思路。

Organizing pneumonia(OP)refers to nonspecific inflammation or formation of granulation tissue in the alveolar space,alveolar duct,or bronchioles.Most of the cases have unclear causes and no unique symptoms,and the imaging has the characteristics of wandering.OP is prone to misdiagnosis or missed diagnosis in the case of complicated with smoking-related interstitial lung disease(SR-ILD).In traditional Chinese medicine,OP is defined as a disease of lung atrophy or lung impediment because of its hidden onset,onset upon contraction,lingering course,repeated attacks,and difficult cure,which are similar to the characteristics of latent pathogen.This article reports one case of OP complicated with SR-ILD and the treatment from the theory of latent pathogen,providing ideas for the clinical diagnosis and treatment of OP.