经方辨治慢性肺炎的临床体会

2022年9月第12卷第17期CHINAMEDICINEANDPHARMACYVol.12No.17September202279·中医研究·经方辨治慢性肺炎的临床体会李炎辉Δ　　孙宁宁　　牛婷媛Δ　　武　鑫　　高剑峰▲河南中医药大学医学院，河南郑州　450046[摘要]肺炎是临床中常见的呼吸系统疾病，具有季节性明显、发病率高的特点，其中慢性肺炎是最常见的发病类型。目前治疗主要以西医的抗感染为主，治疗方式单一，且治疗效果欠佳，易复发。祖国医学虽没有“肺炎”一名，结合临床表现可以归于“咳嗽”“哮喘”范畴，按照具体的发病情况辨别虚实。虚证多由太阴脾胃气血不足，运输无力，导致痰饮内生，外有饮邪诱发，痰饮上逆冲肺而发；实证多以阳明内热郁积中焦，导致气机不通，郁于胸中而发。利用经方辨治慢性肺炎从病因病机出发，抓住患者的主症，明辨用方，已得到初步效果。本文从六经入手，对于慢性肺炎患者首辨病性阴阳，继辨病情归经，最后两者结合再辨方证，以求得方证对应，尽愈诸病。截至目前中医药虽未得到完全认可，但是其治病效果正在逐步得到宣传，本文从临床常见病例中列举一二，从经方论治中得到临床体会，希望能够为中医药的发展尽一份力量。[关键词]经方；六经辨证；慢性肺炎；临床体会[中图分类号]R259　　　[文献标识码]A　　　[文章编号]2095-0616（2022）17-0079-05ClinicalexperienceinthedifferentiationandtreatmentofchronicpneumoniawithclassicprescriptionsLI　Yanhui　　SUN　Ningning　　NIU　Tingyuan　　WU　Xin　　GAO　JianfengSchoolofMedicine,HenanUniversityofChineseMedicine,Henan,Zhengzhou450046,China[Abstract]Pneumoniasarecommonrespiratorydiseasesinclinic.Theyhavethefeaturesofobviousseasonalityandhighincidence.Inthem,chronicpneumoniaisthemostcommontype.Atpresent,thetreatmentofwesternmedicineismainlyanti-infection,withsingletreatmentmode,andthetherapeuticefficacyispoorandeasytorelapse.AlthoughthereisnonameofpneumoniainChinesemedicine,itcanbeclassifiedintocoughandasthmacombinedwithclinicalmanifestations.Accordingtothespecificonsetcondition,itisdividedintodeficiencysyndromeandexcesssyndrome.DeficiencysyndromeisoftenidentifiedasdeficiencyofQiandbloodinthespleenandstomachmeridiansoffoot-Taiyinandweakbloodflow,resultinginendogenousphlegm-fluid.ItisexternallyinducedbyYinxieandinternallyinducedbytheupwardretrogradeflowofphlegm-fluidintothelungs.TheexcesssyndromeismostlyinducedbystagnationofZhongjiaoandinternalheatinYangming,whichleadstoQiobstructionanddepressioninthechest.Thedifferentiationandtreatmentofchronicpneumoniawithclassicprescriptionshasachievedpreliminaryresultsintermsofetiologyandpathogenesis,graspingthemainsymptomsofpatientsandclearlyidentifyingtheprescriptions.Startingwiththesixmeridians,thepathogenicYinandYangofchronicpneumoniapatientsisfirstdistinguishedinthispaper,thentheillnessandmeridiantropismaredifferentiated.Andfinally,theprescriptionandsyndromearebothcombinedanddifferentiated,soastoobtainthecorrespondingprescriptionforspecificsyndromeandcurealltheabovediseases.Uptonow,althoughtraditionalChinesemedicinehasnotbeenfullyrecognized,itstherapeuticefficacyisgraduallybeingpublicized.Someclinicalexperienceobtainedfromthedifferentiationandtreatmentwithclassicprescriptionsbytheauthorislistedinthispaper,aimingtomakeacontributiontothedevelopmentoftraditionalChinesemedicine.[Keywords]Classicprescriptions；Syndromedifferentiationofsixmeridians；Chronicpneumonia；Clinicalexperience肺炎是指各种原因引起肺泡发生炎症反应，病程超过3个月者可定义为慢性肺炎。是以反复咳嗽、喘息为主要临床表现的一种呼吸系统疾病，成年人的肺炎多合并有多种原发性疾病[1-2]，中老年人是本病的高发人群，这与老年人免疫功能低下、器官功能减退有一定关联[3]。近年来随着环境污染问题的逐年加重，慢性肺炎患病人数也越来越多，且[基金项目]河南省自然科学基金（202300410267）；河南省重点研发与推广专项项目（212102311082）；河南省高等学校青年骨干教师培养计划（2021GGJS085）；河南中医药大学2021年度研究生科研创新能力提升计划项目（2021KYCX043）。Δ河南中医药大学医学院病理学与病理生理学专业在读硕士研究生▲通讯作者