| 引用本文: |
高婧, 纪伟.从三焦气化理论探析特发性炎性肌病合并肺间质病变中医病机与治法[J].湖南中医药大学学报,2025,45(11):2176-2181[点击复制] |
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| 从三焦气化理论探析特发性炎性肌病合并肺间质病变中医病机与治法 |
| 高婧,纪伟 |
| (南京中医药大学附属医院, 江苏 南京 210029) |
| 摘要: |
| 基于三焦气化理论，从中医视角探析特发性炎性肌病合并肺间质病变的病因病机，认为以肺、脾、肾三脏亏虚为本，以痰、瘀、热毒壅盛为标。三焦作为气血津液运行的通道，若其气化失司，则可形成痰、瘀、热毒的恶性循环，壅滞脏腑组织络脉，加重病情。三焦气化与肺的功能密不可分：上焦失宣则肺气壅滞、营卫不和，中焦失运则脾虚湿困、痰浊内生，下焦失摄则肾失纳气、气逆于上。以疾病进展为轴，将特发性炎性肌病合并肺间质病变分为炎症期、纤维组织增生期、肺间质纤维化期。结合病机的动态演变和病情进展，综合分析提出治则：炎症期宜清热解毒、宣肺祛邪，纤维组织增生期宜除瘀化痰、清畅肺络，肺间质纤维化期宜散积通痹、补肺益肾，且治疗过程中宜时刻把握虚、痰、瘀、热毒的关键病理因素，以期恢复三焦通利，调畅全身气机。 |
| 关键词: 特发性炎性肌病 肺间质病变 三焦气化 肺络痹阻 痰瘀 病机 |
| DOI：10.3969/j.issn.1674-070X.2025.11.021 |
| 投稿时间：2025-06-24 |
| 基金项目:江苏省中医药科技发展计划项目(ZX2022A1)。 |
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| TCM pathogenesis and therapeutic methods of idiopathic inflammatory myopathy complicated with interstitial lung disease from the perspective of sanjiao qi transformation theory |
| GAO Jing, JI Wei |
| (Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu 210029, China) |
| Abstract: |
| Based on the sanjiao qi transformation theory, this study explores the etiology and pathogenesis of idiopathic inflammatory myopathy complicated with interstitial lung disease from the perspective of TCM. It is believed that the root lies in the deficiency of the lung, spleen, and kidney, while the manifestations are characterized by the excessive accumulation of phlegm,blood stasis, and heat-toxin. Since sanjiao is the channel for the circulation of qi, blood, and body fluids, its impaired qi transformation function can lead to a vicious cycle of phlegm, blood stasis, and heat-toxin, which obstructs the collateral vessels of the zang-fu organs and tissues, thereby exacerbating the disease. The qi transformation of the sanjiao is closely related to lung function: impaired diffusion in the upper jiao results in lung qi stagnation and disharmony between the Ying-nutrients and Wei-defence; impaired transportation in the middle jiao leads to spleen deficiency, dampness retention, and endogenous phlegm production; and impaired containment in the lower jiao causes kidney failing in to receive qi and upward qi rebellion. Taking disease progression as the axis, idiopathic inflammatory myopathy complicated with interstitial lung disease is divided into three stages: the inflammatory stage, the fibrous tissue proliferation stage, and the pulmonary interstitial fibrosis stage. Considering the dynamic evolution of the pathogenesis and disease progression, a comprehensive analysis proposes the following treatment principles: in the inflammatory stage, clearing heat and detoxifying, as well as dispersing lung qi and eliminating pathogenic factors,should be prioritized; in the fibrous tissue proliferation stage, removing blood stasis and resolving phlegm, along with clearing and unblocking the lung collaterals, are recommended; and in the pulmonary interstitial fibrosis stage, dispersing accumulations,unblocking obstruction, and tonifying the lung and kidney are advised. Moreover, throughout the treatment process, it is crucial to closely monitor the key pathological factors of deficiency, phlegm, blood stasis, and heat-toxin, aiming to restore the smooth flow of sanjiao and regulate the overall qi movement in the body. |
| Key words: idiopathic inflammatory myopathy interstitial lung disease sanjiao qi transformation lung collateral obstruction phlegm and blood stasis pathogenesis |
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