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Quote : 李刚, 郭彦荣, 韩玉霞, 彭明浩, 宋桂华, 张岩, 赵坤, 陈小松.赵坤基于“肺管-肺脉-肺络”分期辨治儿童难治性肺炎支原体肺炎经验[J].湖南中医药大学学报英文版,2026,46(2):394-399.[Click to copy ]
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赵坤基于“肺管-肺脉-肺络”分期辨治儿童难治性肺炎支原体肺炎经验
李刚,郭彦荣,韩玉霞,彭明浩,宋桂华,张岩,赵坤,陈小松
(郑州大学附属儿童医院, 河南 郑州 450000;河南中医药大学第一附属医院, 河南 郑州 450000)
摘要:
    难治性肺炎支原体肺炎是由肺炎支原体肺炎进展而来,儿童发病率偏高,临床上易并发多器官组织损伤。赵坤教授创新性提出“肺管-肺脉-肺络”学术思想,认为本病病机演变与该学术思想有密切关系,指出肺管之病多在气分,主要病理因素为热、毒、痰;肺脉之病多在营血分,主要病理因素为痰、瘀、热、毒;肺络之病多为正虚邪恋的迁延期,病理因素为虚、痰、瘀、热、毒。治疗上倡导分期论治,采用截断扭转的辨治思路:肺管阶段治以清热解毒、开肺化痰,肺脉阶段治以解毒散结、逐瘀化痰,肺络阶段治以托毒散邪、扶正通络。基于该学术思想治疗儿童难治性肺炎支原体肺炎取得了较好的临床疗效,附验案一则,以期为治疗该病提供新思路。
关键词:  肺管  肺脉  肺络  肺炎支原体  难治性肺炎支原体肺炎  分期辨治
DOI:10.3969/j.issn.1674-070X.2026.02.025
Received:September 23, 2025  
基金项目:国家自然科学基金项目(82274578);全国名老中医药专家传承工作室建设项目(国中医药人教函[2022]75)号);河南省第三批中医药青苗人才项目(豫卫中医药科教[2024]4号);2023年科技攻关联合共建课题(LHGJ20230687)。
ZHAO Kun's experience in staged differentiation and treatment of refractory Mycoplasma pneumoniae pneumonia in children based on “lung tube-lung vessel-lung collateral” theory
LI Gang, GUO Yanrong, HAN Yuxia, PENG Minghao, SONG Guihua, ZHANG Yan, ZHAO kun, CHEN Xiaosong
(Children's Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan 450000, China;The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, Henan 450000, China)
Abstract:
    Refractory Mycoplasmal pneumoniae pneumonia (RMPP) is a progression of Mycoplasma pneumoniae pneumonia (MPP), with a high incidence rate in children, and is clinically prone to complicated multi-organ tissue damage. Professor ZHAO Kun innovatively proposed the academic viewpoint of "lung tube-lung vessel-lung collateral", believing that the pathogenesis evolution of this disease is closely related to this theory. He pointed out that diseases of the lung tube are mostly in the qi phase, with the main pathological factors being heat, toxin, and phlegm; diseases of the lung vessel are mostly in the Ying-nutrient blood phase, with the main pathological factors being phlegm, blood stasis, heat, and toxin; diseases of the lung collateral are mostly in the protracted phase of deficiency of healthy qi and lingering pathogenic factors, with the pathological factors being deficiency, phlegm, blood stasis, heat, and toxin. In terms of treatment, he advocates for staged differentiation and treatment, adopting the approach of intercepting and reversing the disease progression in differentiation and treatment. In the lung tube stage, treatment focuses on clearing heat and removing toxin, and dispersing the lung to transform phlegm; in the lung vessel stage, treatment focuses on removing toxin and resolving mass, and removing blood stasis and transforming phlegm; in the lung collateral stage, treatment focuses on expelling pathogenic factors, reinforcing healthy qi, and unblocking the collateral. Based on this theory, treating RMPP in children has achieved good clinical efficacy. A verified medical record is attached to provide a new approach for its treatment.
Key words:  lung tube  lung vessel  lung collateral  Mycoplasma pneumoniae  refractory Mycoplasma pneumoniae pneumonia  staged differentiation and treatment
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