张国梁以宣肺清热、化痰散结法论治肺结节经验介绍

Experience of ZHANG Guoliang in Treating Pulmonary Nodules with Methods of Diffusing Lung and Clearing Heat and Dissolving Phlegm and Dissipating Masses

总结张国梁主任治疗肺结节(PN)的经验,其认为本病的基本病机是痰热蕴肺,肺失宣肃,日久夹瘀酿毒成积,结合胸部CT显示的结节灶密度、大小及形态,可分为痰热蕴肺、痰瘀互结、痰热酿毒等证型,治疗重点在于宣肺清热、化痰散结,自拟宣肺散结汤作为基础方,辨证论治,痰热蕴肺证治以清肺化痰散结,痰瘀互结证兼以化痰祛瘀散结,痰热酿毒证治以化痰散结、抗癌解毒,治疗始终注意顾护正气。

This paper summarizes the experience of Chief Physician ZHANG Guoliang in treating pulmonary nodules(PN).He believes that the basic pathogenesis of this disease is phlegm-heat accumulation in the lung,the lung failing to diffuse and govern descent,and accumulation of blood stasis and toxin over time.Combined with the density,size,and morphology of the nodule lesions shown on CT scans of the chests,it can be divided into several syndrome types,namely phlegm-heat accumulation in the lung,binding of phlegm and stasis,and phlegm-heat generating toxin.The treatment focuses on diffusing the lung and clearing heat,and resolving phlegm and dissipating masses;syndrome differentiation and treatment is performed with self-formulated Xuanfei Sanjie Decoction as the basic prescription.The syndrome of phlegm-heat accumulation in the lung is treated by clearing the lung,resolving phlegm and dissipating masses,the syndrome of binding of phlegm and stasis by resolving phlegm,dispelling stasis,and dissipating masses,and the syndrome of phlegm-heat generating toxin by resolving phlegm and dissipating masses,and anti-cancer and detoxifying.The treatment always pays attention to protecting the healthy qi.