文章摘要
许丹阳,宋欣伟.宋欣伟治疗系统性硬化症合并肺间质纤维化经验探析[J].浙江中医药大学学报,2022,(5):527-530.
宋欣伟治疗系统性硬化症合并肺间质纤维化经验探析
Clinical Experience of SONG Xinwei in Treating Systemic Sclerosis Complicated with Pulmonary Interstitial Fibrosis
DOI:10.16466/j.issn1005-5509.2022.05.011
中文关键词: 系统性硬化症  肺间质纤维化  肺痹  脏腑辨证  名老中医经验  医案  宋欣伟
英文关键词: systemic sclerosis  pulmonary interstitial fibrosis  lung paralysis  viscera syndrome differentiation  experiences of famous and old Chinese medicine doctors  medical records  SONG Xinwei
基金项目:宋欣伟全国名老中医药专家传承工作室项目(国中医药人教函[2018]134号)
作者单位
许丹阳 浙江中医药大学 杭州 310053 
宋欣伟 浙江中医药大学附属第一医院 
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中文摘要:
      [目的] 探讨总结宋欣伟教授运用中医脏腑相关理论治疗系统性硬化症合并肺间质纤维化的临床经验。[方法] 通过查阅文献,随师临诊,整理医案,以脏腑辨证思想为指导,从肺、脾、肾等脏腑的寒热虚实入手,探讨宋师治疗系统性硬化症合并肺间质纤维化的临床经验,对其病名归属、病因病机以及依据脏腑辨治的具体组方用药规律予以总结分析,并提供医案一则。[结果] 宋师认为本病归属“肺痹”范畴,早中期类似于“肺胀”,晚期相当于“肺痿”,基本病机为“上实下虚”,痰气为要,临证时多从肺逆作咳,化痰为要;脾胃失和,升降为枢;肾虚作喘,补益得宜三方面进行辨证论治,常选用旋覆代赭汤、三子养亲汤、五味消毒饮、六味地黄汤等方剂进行治疗,处以相应药物加减。文中所附医案,宋师辨为病久体虚、痰热壅肺证,早期清肺化痰,后期培补脾肾、豁痰散结,方拟旋覆代赭汤合三子养亲汤、千金苇茎汤加减,取得良好疗效。[结论] 宋师以肺、脾、肾为主要脏腑,抓住痰、气、虚三点治疗系统性硬化症合并肺间质纤维化,注重审证辨因,灵活用药,能够有效缓解患者临床症状、改善生活质量,与西医治疗相辅相成,其经验值得学习和传承。
英文摘要:
      [Objective] To investigate and summarize the clinical experience of Professor SONG Xinwei in the treatment of systemic sclerosis complicated with pulmonary interstitial fibrosis by using the theory of viscera syndrome differentiation and treatment of traditional Chinese medicine(TCM). [Methods] Through literature review, clinical follow-up and medical records collation, guided by the theory of viscera syndrome differentiation, starting from the cold and heat, deficiency and excess of viscera such as lung, spleen and kidney, this paper discussed the clinical experience of Professor SONG in the treatment of systemic sclerosis complicated with pulmonary interstitial fibrosis, summarized and analyzed the attribution of disease name, etiology and pathogenesis, and the specific prescription medication rules based on viscera differentiation and treatment, and provided a clinical case. [Results] Professor SONG believes that the disease belongs to the category of “lung paralysis”, which is similar to “lung distention” in the early and middle stages, and is equivalent to “lung flaccidity” in the late stage. The basic pathogenesis of this disease is “upper excess and lower deficiency”, and phlegm and Qi are the keys. In clinic, syndrome differentiation and treatment are mainly carried out from three aspects: Cough and resolving phlegm due to lung inversion, spleen and stomach disharmony, ascending and descending is the hub, kidney deficiency leads to asthma, tonifying is beneficial, and Xuanfu Daizhe Decoction, Sanzi Yangqin Decoction, Wuwei Xiaodu Decoction, Liuwei Dihuang Decoction and other prescriptions are often used for treatment, with corresponding drugs. In this paper, the attached medical records, Professor SONG identified as a long-term body deficiency, phlegm heat obstructing the lung syndrome. In the early stage, clear the lung and resolve phlegm; in the later stage, tonify the spleen and kidney, eliminate phlegm and dissipate mass, Xuanfu Daizhe Decoction was adopted combined with Sanzi Yangqin Decoction, Qianjin Weijing Decoction, and good results were achieved. [Conclusion] Starting from the lung, spleen and kidney as the main viscera, Professor SONG seizes the three points of phlegm, Qi and deficiency, pays attention to syndrome differentiation and flexible medication, which can effectively relieve the clinical symptoms of patients and improve the quality of life, complemented with western medicine treatment, and his experience is worth learning and inheriting.
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