| 伍照楚,张立山,张晶,等.柴胡桂枝干姜汤合当归芍药散治疗间质性肺病的临证运用[J].浙江中医药大学学报,2023,47(11):1315-1318. |
| 柴胡桂枝干姜汤合当归芍药散治疗间质性肺病的临证运用 |
| Clinical Application of Chaihu Guizhi Ganjiang Decoction Combined with Danggui Shaoyao Powder in Treating Interstitial Lung Disease |
| DOI：10.16466/j.issn1005-5509.2023.11.013 |
| 中文关键词: 柴胡桂枝干姜汤 当归芍药散 寒热错杂 血虚水盛 间质性肺病 名医经验 |
| 英文关键词: Chaihu Guizhi Ganjiang Decoction Danggui Shaoyao Powder cold-heat complex deficiency of blood and excess retained fluid interstitial lung disease experience of famous doctors |
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| 中文摘要: |
| [目的] 总结柴胡桂枝干姜汤合当归芍药散治疗间质性肺病(interstitial lung disease，ILD)的临证运用经验。[方法] 分析ILD的病机、柴胡桂枝干姜汤合当归芍药散合方用药的特点以及合用经方治疗ILD的特色，从临床实践中总结治疗思路及经验，并附医案加以验证。[结果] ILD患者肾虚在前，肺痹于后，脾胃受损，体内水饮不化，水饮、瘀血等病理产物在体内淤积，加之常用激素治疗，阳亢阴伤，有酿为坏病之嫌。肝肺气机失和、肺肾摄纳失常、肝脾升降不利等诸多因素相互影响，津血亏虚者又最易出现内里虚热之象，上热下寒常见，形成一派寒热错杂、血虚水盛的病机。柴胡桂枝干姜汤可以调整寒热，当归芍药散可健脾养血利水，二方合用，有平调寒热、养血利水之效。所举ILD医案二则，患者虽病程、症状不同，但均有寒热错杂、血虚水盛之象，以平调寒热、养血利水为治则，治疗后诸症好转。[结论] 合用经方治疗以寒热错杂、血虚水盛为特点的ILD，常有较好的临床疗效，这也强调了灵活运用经方的重要性，具有创新性，值得推广。 |
| 英文摘要: |
| [Objective] To summarize the clinical application of Chaihu Guizhi Ganjiang Decoction combined with Danggui Shaoyao Powder in the treatment of interstitial lung disease(ILD). [Methods] To analyze the pathogenesis of ILD， the characteristics of the medicines used in Chaihu Guizhi Ganjiang Decoction combined with Danggui Shaoyao Powder， as well as the characteristics of the treatment of ILD by combining with the classical prescription， and to summarize the therapeutic ideas and experiences from clinical practice， with medical cases for verification. [Results] Patients with ILD have kidney deficiency coming first， followed by lung paralysis， damage to the spleen and stomach， failure to transform water-drink in the body， and accumulation of water-drink， blood stasis and other pathological products in the body. In addition to hormone therapy， Yang is hyperactive and Yin is injured， or there is a suspicion of bad disease， the liver and lung Qi is out of harmony， the lung and kidney are not in normal intake， the liver and spleen are not conducive to lifting and lowering， etc. Many organs interact with each other， and those with deficiency of fluid and blood are most likely to have internal signs of deficiency heat， and upper heat and lower cold are often manifested， forming a situation of cold-heat complex， deficiency of blood and excess retained fluid. Chaihu Guizhi Ganjiang Decoction can simultaneously regulate both cold and heat， and Danggui Shaoyao Powder can strengthen the spleen and nourish blood and promote diuresis. The two cited cases of ILD， although the patients’ course of disease， symptoms were different， but they all had the phenomenon of cold-heat complex， deficiency of blood and excess retained fluid.By taking regulating cold and heat， nourish blood and promote diuresis as the principle of treatment， the treatment achieved good results. [Conclusion] Combined use of classical prescriptions in the treatment of ILD characterized by a cold-heat complex and blood deficiency and water stasis has yielded excellent clinical results， emphasizes the importance of flexible use of calssical prescriptions， which is innovative and worthy of promotion. |
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