1.中国中医科学院西苑医院,北京市海淀区西苑操场1号,100091
2.北京中医药大学研究生院
miaoqing55@sina.com,(010)62835376
收稿:2021-08-06,
修回:2021-08-31,
纸质出版:2022-01-02
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范艺龄,袁沙沙,宗慧琪等.特发性肺纤维化相关咳嗽的中医治疗策略[J].中医杂志,2022,63(01):21-25.
FAN Yiling,YUAN Shasha,ZONG Huiqi,et al.Traditional Chinese Medicine Treatment Strategies for Idiopathic Pulmonary Fibrosis-related Cough[J].Journal of Traditional Chinese Medicine,2022,63(01):21-25.
范艺龄,袁沙沙,宗慧琪等.特发性肺纤维化相关咳嗽的中医治疗策略[J].中医杂志,2022,63(01):21-25. DOI: 10.13288/j.11-2166/r.2022.01.006.
FAN Yiling,YUAN Shasha,ZONG Huiqi,et al.Traditional Chinese Medicine Treatment Strategies for Idiopathic Pulmonary Fibrosis-related Cough[J].Journal of Traditional Chinese Medicine,2022,63(01):21-25. DOI: 10.13288/j.11-2166/r.2022.01.006.
咳嗽是特发性肺纤维化(IPF)的主要症状之一,剧烈的顽固性咳嗽严重影响患者的生活质量,并与IPF疾病进展相关。认为肺、脾、肾三脏虚损是IPF相关咳嗽的发病基础,其中尤以肺肾气虚最为关键;同时脏腑虚损之体又极易内生痰、瘀,或是感受风、寒之邪,导致肺失宣降,加剧咳嗽。临床主张以“虚嗽”论治IPF相关咳嗽,具体疗法包括补肾益精法,重用熟地黄、山茱萸补益肾精、纳气固本止咳;调补肺脾、斡旋中焦气机法,主以黄芪补胸中大气,以半夏泻心汤斡旋中焦气机;宣肺降气、敛肺止咳法,以金沸草散、止嗽散宣肺降气,以五味子、白芍敛肺止咳。诸法并用,能有效控制IPF相关咳嗽,改善患者生活质量。
Cough is one of the main symptoms of idiopathic pulmonary fibrosis (IPF). Violent and refractory coughing seriously affects the patients' quality of life and is related to the progression of IPF. It is believed that lung-spleen-kidney deficiency, especially
qi
deficiency of lung-kidney is the basic pathogenesis of IPF-related cough. Simultaneously, patients with deficiency of
zang
-
fu
(脏腑) organs are prone to generating phlegm and stasis, or easily affected by pathogenic wind and cold, which leads to lung failing to diffuse and govern descent and cough aggravated. In clinical practice, it is suggested to treat the IPF-related cough from the perspective of “deficiency cough”. The re-commended methods include supplementing kidney and boosting essence, which can use Shudihuang (
Radix Rehmanniae Praeparata
) and Shanzhuyu (
Fructus Corni
) to supplement and boost kidney essence, receive
qi
reception, consolidate the root and relieve cough; the method of regulating and supplementing lung-spleen, and harmonizing
qi
movement of middle
jiao
(中焦) is also advised, which can use Huangqi (
Astragalus memebranaceus
) to supplement chest
qi
, and
Banxia Xiexin Decoction
(半夏泻心汤) to harmonize
qi
movement of middle
jiao;
the last recommended method is diffusing and governing descent of lung
qi,
astringing the lung and relieving cough, which uses
Jinfeicao Powder
(金沸草散) and
Zhisou Powder
(止嗽散) to diffuse and govern descent of lung
qi,
and Wuweizi (
Fructus Schisandrae Chinensis
) and Baishao (
Radix Paeoniae Alba
) to astringe the lung and relieve the cough. The combined use of all these methods can effectively control the IPF-related cough and improve the patients' quality of life.
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