从偏颇体质论孤立性肺结节的中医辨治
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摘要
通过临床观察和相关文献分析,总结孤立性肺结节患者常见体质类型,探讨孤立性肺结节的辨体论治思路。孤立性肺结节的中医病机为气虚、气郁或阴虚,导致痰瘀互结胶固难化而形成结节,患者体质以气虚质、气郁质、阴虚质为主,可见不同的兼夹状态,治疗重在益气健脾、疏肝理肺、养阴润燥,并兼顾消痰散结。通过纠正偏颇体质可实现人体内部气血阴阳的平衡,有助于稳定症状缺失、无证可辨孤立性肺结节患者的病灶,防止结节恶变,体现了整体治疗观的应用。
The common constitution types of the patients with solitary pulmonary nodules were summarized on the basis of clinical observation and the analysis of relevant literatures,and then the differentiation and treatment of solitary pulmonary nodules based on biased constitution were explored. It is showed that the pathogenesis of solitary pulmonary nodules in traditional Chinese medicine(TCM)is related to the refractory phlegm blended with blood stasis due to Qi deficiency, Qi stagnation or yin deficiency. The patients with solitary pulmonary nodules were dominated by Qi deficiency constitution,Qi stagnation constitution and yin deficiency constitution,and usually complicated with various pathogenic factors. The treatment of solitary pulmonary nodules should be focused on replenishing qi and invigorating spleen, soothing liver and regulating lung, nourishing yin and moistening dryness,combined with removing phlegm and resolving mass. By correcting the biased constitution,the balance of Qi,blood,yin and yang of human body can be achieved,which is helpful to stabilize the nodules and prevent the malignancy of nodules of the solitary pulmonary nodule patients without obvious symptoms or TCM syndromes,and embodies the holistic treatment concept of TCM.
The common constitution types of the patients with solitary pulmonary nodules were summarized on the basis of clinical observation and the analysis of relevant literatures,and then the differentiation and treatment of solitary pulmonary nodules based on biased constitution were explored. It is showed that the pathogenesis of solitary pulmonary nodules in traditional Chinese medicine(TCM)is related to the refractory phlegm blended with blood stasis due to Qi deficiency, Qi stagnation or yin deficiency. The patients with solitary pulmonary nodules were dominated by Qi deficiency constitution,Qi stagnation constitution and yin deficiency constitution,and usually complicated with various pathogenic factors. The treatment of solitary pulmonary nodules should be focused on replenishing qi and invigorating spleen, soothing liver and regulating lung, nourishing yin and moistening dryness,combined with removing phlegm and resolving mass. By correcting the biased constitution,the balance of Qi,blood,yin and yang of human body can be achieved,which is helpful to stabilize the nodules and prevent the malignancy of nodules of the solitary pulmonary nodule patients without obvious symptoms or TCM syndromes,and embodies the holistic treatment concept of TCM.
引文
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[2]刘明,姜格宁.孤立性肺结节的良恶性鉴别及处理策略[J].中国胸心血管外科临床杂志,2014,21(1):102.
[3]邱志新,李为民.肺部结节的诊断及处理进展[J].华西医学,2018,33(1):8.
[4]潘秋霞,陈家旭,刘玥芸,等.略论中医证候与体质的关系[J].中国中医基础医学杂志,2017,23(10):1394.
[5]王琦.中医体质三论[J].北京中医药大学学报,2008,31(10):653.
[6]陆王娟,周贤梅.中医体质在肺结节早期诊治中的应用探讨[J].陕西中医,2018,39(4):518.
[7]郭倩倩,赵帅,苏懿,等.中医体质分类与肺癌预后因素相关性分析[J].辽宁中医药大学学报,2012,14(3):112.
[8]赵宇明.情志因素与肿瘤发生发展相关性的研究进展(综述)[J].北京中医药大学学报,2001,24(5):67.
[9]刘敏,朱佳.朱佳教授治疗肺结节中医思路[J].辽宁中医药大学学报,2018,20(9):1.
[10]张挺,李其忠.“同气相求”的理论内涵及其对中医学的影响[J].上海中医药大学学报,2008,22(2):23.
[11]李东,王琦.王琦教授基于“辨体论治”的三辨诊疗模式临床应用探析[J].中华中医药杂志,2012,27(9):2332.
[12]姚实林,张祖志,杨新胜,等.基于974例调查数据的中医兼夹体质分析[J].中西医结合学报,2012,10(5):508.
[13]王珊珊,郭茗,朱垚,等.国医大师周仲瑛教授辨治肺癌经验[J].中华中医药杂志,2015,30(12):4332.
[14]刘瑞,花宝金,侯炜.从气机升降学说论肿瘤病机[J].中医杂志,2014,55(7):544.