刘敬霞教授自拟化痰散结方治疗肺结节临证经验

Clinical Experience of Professor Liu Jingxia in the Treatment of Pulmonary Nodules by Using Self-made Reducing Phlegm and Resolving Masses Prescription

刘敬霞教授认为肺气亏虚是肺结节形成的根本原因,痰湿凝聚成结是贯穿该病的核心病机,环境污染、感受外邪、饮食失宜、劳逸失常是诱发和加重的常见因素。临床辨证“三分论治”:分阶段、分邪正、分脏腑、分兼证;主要从4个方面论治:宣肺解表散邪、补肺化痰散结、肃肺涤痰消节、兼治五脏防变。有外感之邪时,当以解表散邪为主,方用荆防败毒散合射干麻黄汤化裁;解表后重在益气化痰散结,方选补中益气汤合三子养亲汤化裁;宿痰痼结者,以涤痰汤和苏子降气汤化裁。临床治疗发现,清热解毒、活血化瘀类药物不可久用、重用。刘教授自拟化痰散结方治疗肺结节,临床疗效显著。

Based on the basic theory of traditional Chinese medicine,Professor Liu Jingxia believes that deficiency of lung-qi is the fundamental cause of the formation of pulmonary nodules,and phlegm-dampness agglomeration runs through the core pathogenesis of the disease.Environmental pollution,exogenous pathogenic factors,improper diet and work-rest disorder are the common factors inducing and aggravating.Clinical syndrome differentiation and“three-stage treatment”as follows:stages,vital qi and pathogen,zang-fu,sub-syndrome.In addition,it mainly treats from four aspects as follows:dispersing the lung and relieving exterior and dispersing pathogenic factors,tonifying the lung,resolving phlegm and dispersing nodules,purging the lung,dispelling phlegm and eliminating dampness,simultaneously treating the five zang-organs to prevent and change.When there are exogenous pathogenic factors,it is mainly to solve exterior pathogenic factors and disperse them,and use Jingfang Baidu powder combined with Shegan Mahuang decoction.Supplementing qi and resolving phlegm and clearing knots should select Buzhong Yiqi decoction and Sanzi Yangqin decoction.For persistent phlegm,Ditan decoction and Suzi Jiangqi decoction should be applied.Clinical treatment found that heat-clearing and detoxification,blood-activating and stasis-resolving drugs can not be used for a long time and repeated use.Professor Liu Jingxia's self-made resolving phlegm and dispersing knot prescription in the treatment of pulmonary nodules has significant clinical effect.