基于张景岳阴阳一体观探讨类风湿关节炎相关间质性肺病急性加重的治疗

Discussion on the Treatment of Acute Exacerbation of Rheumatoid Arthritis-Associated Interstitial Lung Disease Based on ZHANG Jingyue's View of Yin-Yang Holism

基于张景岳阴阳一体观,探讨类风湿关节炎相关间质性肺病(RA-ILD)急性加重的病因病机及治法。认为RA-ILD急性加重的基础为真阴不足、阴不制阳;外邪侵袭是RA-ILD急性加重的常见诱因。治疗时首当潜降相火,方用引火汤加减;相火已潜则专注于培补阴阳,若为真阴亏虚为主,可选用左归丸加减,若真阳亏虚亦明显,可选用右归丸加减。阴阳平衡,则病情得解。

This article is based on ZHANG Jingyue's theory of yin-yang holism to explore the etiology,pathogenesis,and treatment of acute exacerbation of rheumatoid arthritis-associated interstitial lung disease(RA-ILD).It is believed that the foundation of acute exacerbation of RA-ILD lies in real yin insufficiency and yin fail to control yang;external pathogen attacking is a common cause of acute exacerbation of RA-ILD.For treatment,it is important to first suppress ministerial fire by prescribing modified Yinhuo Decoction(引火汤);if ministerial fire submerged,focus should be on nourishing both yin and yang;if real yin deficiency is the main issue,modified Zuogui Pill(左归丸)should be used;if real yang deficiency is prominent as well,modified Yougui Pill(右归丸)can be chosen.When yin and yang balanced,the disease could be solved.