益肾固本法治疗稳定期慢性阻塞性肺疾病的用药经验

Medication Experience in the Treatment of Chronic Obstructive Pulmonary Disease at Stable Stage by Tonifying the Kidney and Consolidating the Constitution

慢性阻塞性肺疾病(COPD)是一种以慢性、进展性气流受限和呼吸道症状为表现的肺部疾病,西医治疗效果尚不完全满意,病情反复加重和高致死率给个人和社会带来沉重的负担。中医药历史悠久,经验丰富,治疗COPD疗效较好。本病多属中医学“喘证”“肺胀”等范畴,曹世宏教授认为,COPD是由多种慢性肺系疾病反复发作,迁延不愈,导致肺气胀满,不能敛降而引起的一种病证。病机为本虚标实,多在久病肺虚的基础上损及五脏,其中尤以肺肾两脏为甚,并强调痰浊和血瘀为其发病的关键病理因素。曹教授治疗稳定期COPD主张衷中参西、取长补短,采用支气管舒张剂吸入等西医基础治疗的同时,联合中药补益肺肾之气,治病求本,其中党参、黄芪、巴戟天等是曹教授临床常用中药,有平补肺脾之气,温补肾阳之功。同时注意化痰祛瘀,因人制宜,临床疗效颇佳。本研究附验案1则以佐证。

Chronic obstructive pulmonary disease(COPD)is characterized by chronic and progressive airflow limitation and respira⁃tory symptoms.The effect of western medical treatment is not yet completely satisfactory.The Recurrent acute exacerbations of COPD and the high mortality rate impose a heavy burden on individuals and society.Traditional Chinese medicine(TCM)has a long history and is quite experienced and effective in the treatment of COPD.COPD means"asthma syndrome"or"lung distension"in Chinese medicine.Professor Cao Shihong believes that the disease is caused by distension of lung qi resulted from a variety of chronic,recurrent and obsti⁃nate pulmonary diseases.Its pathogenesis is composed of deficiency in origin and excess in superficiality.The deficiency of the lung often affected the five viscera,especially the lung and kidney.Professor Cao also emphasizes the crucial importance of phlegm turbidity and blood stasis which are pathological factors of COPD.Professor Cao advocates the combination of the western medicine and Chinese medicine,as there goes a proverb,"overcoming one's weaknesses by acquiring other's strong points".He integrates the use of western basic treatment like the bronchial dilator inhalation with traditional Chinese medicine supplementing the lung and kidney qi at the same time.Prefessor Cao frequently uses those traditional Chinese medicine with the function of tonifying lung and spleen qi and warming and invigorating kidney Yang like Codonopsis Radix,Astragali Radix,Morindae Officinalis Radix and so on.The elimination of phlegm and removal of blood stasis is also stressed.Professor Cao applies proper therapeutic measures in line with individuality,which have good therapeutic efficacy.A case was attached for verification.