徐艳玲教授中医药治疗特发性肺间质纤维化之经验初撷

发布时间：2018-06-08 19:44

本文选题：特发性肺间质纤维化~[1] + 肺痿　；参考：《辽宁中医药大学》2016年硕士论文

【摘要】：特发性肺间质纤维化是一种近年来患病率逐年递增的慢性呼吸系统疾病,已渐渐成为呼吸系统疾病中的常见病和多发病,患病率和致死率均有日益增高的趋势。特发性肺间质纤维化好发于中老年人群,且男性多于女性,临床主要表现为咳嗽、咯痰、进行性加重的劳力性气促。查体时,在双肺底部及靠近胸膜处可以闻及吸气末期VelcroUp音,大多数患者在晚期病情严重时亦可见唇绀、杵状指(趾)等。有关于特发性肺间质纤维化的理化检查,如肺部影像学检查主要以双肺弥漫性病变为主,呈网格状或磨玻璃状改变;肺功能检查则主要体现在限制性的通气障碍以及弥散功能的减低;动脉血气分析常以低氧血症最为多见。本病病程缠绵反复,现代医学对特发性肺间质纤维化治疗效果并不显著,治愈率低,预后也较差。然而,中医药在治疗特发性肺间质纤维化方面,旨在缓解临床症状,延缓疾病进程,临床疗效可观,有很大的优势和潜力。吾师徐艳玲教授系国家中医药管理局优秀中医临床人才,从事呼吸内科的医教研工作三十余载,理论功底深厚,临床经验丰富,尤擅长以中医药及中西医结合治疗呼吸系统疾病。吾师认为本病可以归属到“肺痿”、“肺痹”、“喘证”、“肺胀”等范畴,尤以“肺痿”论治更为恰当。本病系属本虚标实之证,总由外感六淫之邪气,内伤饮食、情志、劳倦等因素,导致痰瘀内结,耗气伤阴,津气大伤,肺失濡养至肺叶痿弱无用,日久至脾、胃、肾等脏腑功能衰惫。吾师在治疗该病时,急性期以祛除外邪、保护正气为主,稳定期以补益脏腑、调和气血为主。本文将从病名、病因病机、经验治疗、自我调护、病案举例等方面对徐艳玲教授治疗特发性肺间质纤维化之宝贵临床经验进行简要分析,以供参阅。
[Abstract]:Idiopathic pulmonary interstitial fibrosis is a kind of chronic respiratory disease which has been increasing year by year in recent years. It has gradually become a common and frequent disease among respiratory diseases, and the morbidity and mortality are increasing day by day. Idiopathic pulmonary interstitial fibrosis is more common in middle and old people than in female. The main clinical manifestations are cough, sputum, progressive aggravation of exertional shortness of breath. At the bottom of the lungs and near the pleura, VelcroUp could be heard at the end of inspiratory period. Most of the patients also had cyanosis and clubbing in the late stage. There are some physical and chemical examination of idiopathic pulmonary interstitial fibrosis, such as pulmonary imaging examination mainly with diffuse lesions of both lungs, with reticular or glass-like changes. Pulmonary function was mainly reflected in restricted ventilation disturbance and decreased diffusion function, and hypoxemia was the most common in arterial blood gas analysis. The course of the disease is repeated, the effect of modern medicine on idiopathic pulmonary interstitial fibrosis is not significant, the cure rate is low, and the prognosis is poor. However, Chinese medicine in the treatment of idiopathic pulmonary interstitial fibrosis, aimed to alleviate clinical symptoms, delay the progress of disease, clinical efficacy is considerable, has great advantages and potential. Professor Xu Yanling, my teacher, is an outstanding Chinese medicine clinical talent of the State Administration of traditional Chinese Medicine. He has been engaged in the teaching and research of respiratory medicine for more than 30 years. Especially good at Chinese medicine and integrated Chinese and Western medicine in the treatment of respiratory diseases. My teacher believes that this disease can be classified to "lung impotence", "lung arthralgia", "asthma syndrome", "lung distension" and so on, especially the treatment of "lung impotence" is more appropriate. This disease belongs to the syndrome of deficiency and deficiency, which is always caused by external factors such as six evil spirits, internal injury of diet, emotion, fatigue, etc., resulting in phlegm and blood stasis, internal knot of qi, injury of Yin, great injury of invigorating qi, loss of lung nourishment to weak and useless lung lobe impotence, long days to spleen, stomach, etc. The kidney and so on viscera function decline exhausted. My teacher in the treatment of the disease, the acute phase to eliminate external evil, mainly to protect qi, stable to replenish the zang-fu organs, mainly to reconcile qi and blood. This article will briefly analyze Professor Xu Yanling's valuable clinical experience in the treatment of idiopathic pulmonary interstitial fibrosis from the aspects of disease name, etiology and pathogenesis, experience therapy, self-regulation and nursing, examples of medical record, etc, for reference.
【学位授予单位】：辽宁中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R259;R249

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