从“怪病多痰”论治弥漫性肺间质疾病

Treatment of Diffuse Interstitial Lung Disease from ”Strange Disease with Phlegm”

弥漫性肺间质疾病(DILD)可由许多原因引起,它作为许多急慢性肺部疾病的共同结局,对人类健康有着严重的危害,特发性肺纤维化(IPF)是临床上一种较为多见的弥漫性肺间质疾病,其发病率、病死率的趋势逐年升高。DILD归属为祖国医学'肺痿''肺痹''咳嗽''喘证''肺胀'等范畴。此病患者病久体虚,肺、脾、肾三脏脏腑虚衰,不能正常发挥功能,日久又可致瘀,并进一步加重了虚,痰瘀热毒在其基础上形成,有相互胶着,使疾病的预后受到严重影响。因此本病的基本病机为本虚标实。近些年来临床上治疗DILD一般多采用中医药或者中西医结合治疗,有一定效果。古书有'怪病多痰'一说,'痰'是人体之津液代谢失常所产生的病理产物,肺、脾、肾三脏功能失调,会导致机体内水液停积、流溢而出为痰为饮,并进一步变生百病,需四诊合参,辨证论治,方能要到病除。DILD无论是中医还是现代医学,均为肺系疾病中的难治性疾病。中医药对该病的治疗有着独特优势,文章从'怪病多痰'论治DILD,以期为临床工作者提供启发。

Diffuse interstitial lung disease is a common outcome of a variety of causes of acute and chronic lung diseases,serious harmful to human health,clinically with idiopathic pulmonary fibrosis.The incidence rate and the mortality rate are increasing year by year.It belongs to Feiwei,Feibi,asthma,cough,asthma and lung inflation in TCM.The pathogenesis of this disease is characterized by deficiency of the lung,spleen and kidney deficiency,marked by phlegm,blood stasis,heat and toxin.And phlegm,heat and toxin are formed on the basis of deficiency and stasis.In recent years,it can be treated with traditional Chinese medicine or combination of TCM and Western medicine,and good curative effect has been achieved.There is an ancient theroy of strange disease with phlegm.Phlegm is the pathological product of body fluid metabolism disorders,especially disorders due to lung,spleen and kidney.DILD is a refractory disease in lung diseases,and Chinese medicine has a unique advantage in the treatment of this disease.At the same time,there is still a lot of need to further explore the content.This paper disscussed the treatment of DILD from the'strange disease with phlegm'in order to provide inspiration for clinical workers.