摘要
肺结节是临床常见病,其病机复杂,日久可成癌。在肺结节的临床诊疗中可应用“辨体-辨病-辨证”三位一体的诊疗模式。辨体质以治病求本,未病先防:针对气虚质治以补肺益气防留滞,阳虚质治以温阳补气防寒凝,气郁质治以理气解郁防郁滞。辨病证以分期对证论治,既病防变:针对结节形成期的痰瘀互结治以化痰祛瘀消癥瘕,结节癌变期的癌毒酿生治以攻毒散结除窠囊,结节术后期的正气羸弱治以燮理阴阳扶正气。三辨结合,融入中医“治未病”的思想,明晰肺结节动态变化的病机特点并对症施治,为临床中医药防治肺结节提供参考。
Lung nodules are a common clinical condition with a complex pathogenesis and may develop into cancer over time.In the clinical diagnosis and treatment of lung nodules,the"three-in-one"model of differentiating constitution-disease-syndrome can be applied.Constitution differentiation addresses the root cause and prevents disease before its onset:for qi deficiency constitution,treatment focuses on tonifying the lung and boosting qi to prevent retention;for yang deficiency constitution,treatment aims to warm yang and supplement qi to prevent cold-induced coagulation;for qi depression constitution,treatment emphasizes regulating qi and relieving depression to prevent stagnation.Disease and syndrome differentiation guide treatment according to stage and symptoms to prevent disease progression:in the nodule formation stage with phlegm and blood stasis intermingling,treatment focuses on dissolving phlegm and removing blood stasis to eliminate masses;in the nodule canceration stage with emerging cancer toxins,therapy targets toxins and disperses nodules to eliminate cysts;in the post-operative stage with weakened vital qi,treatment emphasizes harmonizing yin and yang and supporting vital qi.The integration of these three differentiations embodies the traditional Chinese medicine(TCM)concept of"preventive treatment of disease",clarifies the pathogenesis underlying the dynamic changes of lung nodules,and guides stage-and symptom-specific interventions,providing a reference for the prevention and management of lung nodules with TCM in clinical practice.
作者
曹艳冬
李雁
田丽
CAO Yandong;LI Yan;TIAN Li(Emergency Department of Dongzhimen Hospital,Beijing University of Chinese Medicine,Beijing 100700,China)
出处
《北京中医药》
2025年第10期1347-1350,共4页
Beijing Journal of Traditional Chinese Medicine
基金
北京中医药大学东直门医院临床研究和成果转化能力提升试点项目(DZMG-MLZY-23004)
北京中医药“薪火传承3+3工程”室站建设项目(2020-SZ-A-47)。
关键词
肺结节
辨体质
辨病
辨证
lung nodule
constitution differentiation
disease differentiation
syndrome differentiation
