国医大师洪广祥从“痰瘀伏肺”论治慢性阻塞性肺疾病急性加重期经验

Experience of TCM master HONG Guangxiang in treating acute exacerbation of chronic obstructive pulmonary disease from‘phlegm and blood stasis in lung'

国医大师洪广祥提出“气阳虚弱,痰瘀伏肺”是慢性阻塞性肺疾病的核心病机,其中“痰瘀伏肺”为慢性阻塞性肺疾病的夙根,急性期以“痰瘀”标实为主,内外诸邪引动为因。洪广祥认为治疗慢性阻塞性肺疾病急性期时应注重四诊合参,通过望痰色、闻咳声,首辨寒热;审肌筋、查咽部,“巧”祛痰瘀;对于痰瘀俱实、气道壅塞严重者,法以“治痰治瘀以治气为先”;危重患者,当虚实并治,防止传变,整个治疗过程中又贯以“治肺不远温”的学术思想。

TCM master HONG Guangxiang proposed that‘qi yang weakness and phlegm stasis in lung"is the core pathogenesis of chronic obstructive pulmonary disease(COPD),with‘phlegm and blood stasis in lung'being the fundamental cause of COPD.During the acute phase,‘phlegm stasis'is the main manifestation,triggered by various internal and external pathogenic factors.HONG Guangxiang believed that in the treatment of acute exacerbations of COPD,emphasis should be placed on the four diagnostic methods,including observing the color of phlegm and listening to the sound of coughing to differentiate between cold and heat patterns.Palpating the muscles and tendons and examining the throat are used to skillfully eliminate phlegm stasis.For patients with both phlegm and stasis,and severe airway obstruction,the focus should be on‘treating phlegm and stasis to treat qi first'.For critically ill patients,both deficiency and excess should be treated to prevent disease progression,and the overall treatment process should adhere to the academic concept of‘treatment of lung not far from'.