吴银根补虚泻实辨治肺系顽疾

发布时间：2019-02-14 07:03

【摘要】：吴银根教授认为肺系顽疾特点是病情反复,不易控制,往往已经多种治疗,正虚邪实夹杂,亦虚亦实;邪实不宜单纯套用西医抗感染而大肆用苦寒清热、清化痰热方药,避免"闭门留寇"和损伤气阳,致病情加重,变证丛生;肺系顽疾与气阳虚弱、宗气不足、抗御外邪能力低下、免疫调节能力下降密切关联,应"扶正以祛邪"和"祛邪以安正"灵活运用,补虚泻实贯穿始终,至于孰主孰次,依病情、病变阶段不同而异。临证注重温法,将《金匮要略》"病痰饮者,当以温药和之"具体化与系统化,包括温肺化饮、温肺益气、温脾健运、温肾行水化痰,温化痰浊等,代表方剂分别为苓甘五味姜辛汤、补肺汤、苓桂术甘汤合六君子汤、痰饮丸、二陈汤合三子养亲汤;吴老特别强调"肺为气之主,肾为气之根",指出肺系顽疾往往肾虚,肾具"水火"属性,有阴虚阳虚,注重补肾,喜用仙灵脾、巴戟天温肾补气,桑椹、女贞子滋肾填精。附泛细支气管炎、特发性肺间质纤维化、左肺上叶鳞癌术后、慢性咳嗽、支气管哮喘、慢性低热验案。
[Abstract]:Professor Wu Yingen believes that lung disease is characterized by repeated disease, not easy to control, often has many kinds of treatment, the mixture of positive and evil, but also vacuity and solid; It is unsuitable to simply apply western medicine to resist infection and use bitter cold to clear away heat and eliminate phlegm and heat so as to avoid "leaving the aggressors behind closed doors" and damaging Qi Yang, thus aggravating the illness and changing the syndrome. The persistent disease of lung system is closely related to the weakness of Qi Yang, deficiency of qi, low ability of resisting external evil and decreasing ability of immune regulation. It should be used flexibly to "strengthen and dispel evil" and "remove evil to an Zheng". The stage of disease varies according to the state of the disease. Clinical syndromes pay attention to the method of warming, "the synopsis of the Golden Chamber" disease phlegm drink, when warming medicine and its "specific and systematic, including warming the lung to drink, warming the lung to replenish qi, warming the spleen to transport, warm the kidney to water phlegm, warm phlegm turbid, etc. The representative prescriptions are Linggan Wuwei Jiangxin decoction, Bufei decoction, Lingguizhugan decoction and Liujunzi decoction, phlegm and drink pills, Erchen decoction and Sanzi Yangfu decoction; Wu Lao especially stressed that "the lung is the master of Qi and the kidney is the root of Qi", pointing out that the lung system is often characterized by kidney deficiency, kidney with "water and fire" property, yin deficiency and yang deficiency, attention to tonifying the kidney, predilection for the use of Xianling spleen, Morinda officinalis warming the kidney and invigorating qi, mulberry fruit and Ligustrum lucidum to nourish the kidney. With panbronchiolitis, idiopathic pulmonary interstitial fibrosis, left upper lobe squamous cell carcinoma, chronic cough, bronchial asthma, chronic hypothermia.
【作者单位】：上海中医药大学附属龙华医院急诊科;
【基金】：上海市进一步加快中医药事业发展三年行动计划建设项目(No:ZY3-JSFC-2-1006)~~
【分类号】：R249;R256.1

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