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从"窠囊"论治肺结节

Treatment of pulmonary nodules from'Ke-nang'

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肺结节与中医"窠囊"的形态结构、病位、发病特点等高度相似,可以"窠囊"理论论治.朱丹溪如是描绘窠囊之始生,"自气成积,自积成痰,痰夹瘀血,遂成窠囊",其总体病机遵循"郁-痰-瘀"之演变规律,以肝木郁而气积为发病之始,脾土壅而痰生为发病之机,痰瘀上积于肺为发病之果.笔者进一步提出治疗肺结节当从肝、脾、肺三脏同治,升木达郁以截窠囊之源,实土涤痰以通窠囊之道,通络祛瘀以消窠囊之实,以冀丰富"窠囊"理论内涵,并为肺结节的临床治疗提供新思路.
The pulmonary nodules are highly similar to the'Ke-nang'of traditional Chinese medicine in terms of morphology structure,location and onset characteristics,and they can be treated according to the theory of'Ke-nang'.ZHU Danxi such as is the beginning of delineating the Ke-nang,'self qi accumulation,self accumulated phlegm,phlegm clip blood stasis,thus formed Ke-nang',and its overall disease mechanism follows the evolving rule of'stagnation-phlegm-stasis',taking liver stagnation and qi accumulation as the beginning,spleen soil congestion but phlegm growth as the beginning,and accumulation of phlegm and blood stasis in the lung is the result of the disease.The authors further proposed that treatment should be initiated when the same treatment was conducted from liver,spleen,and lung,ascending Mu to relieve depression to cross the source of the Ke-nang,activating soil to pass the way of the Ke-nang,and removing stasis to eliminate the Ke-nang,in order to enrich the connotation of the theory of the'Ke-nang'and provide new ideas for the clinical treatment of lung nodules.

Theory of'Ke-nang'Spleen-earth obstructed and hepatic qi stagnationPhlegm stasis cementationPulmonary nodule

周舒雯、叶欣、黄娅、付西、任益锋、祝捷、由凤鸣

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成都中医药大学附属医院,成都 610075

成都中医药大学肿瘤研究所,成都 610072

"窠囊"理论 木郁土壅 痰瘀胶结 肺结节

四川省科技厅重大科技专项项目中央引导地方科技发展项目

2022ZDZX00222022ZYD0100

2024

中华中医药杂志
中华中医药学会

中华中医药杂志

CSTPCD北大核心
影响因子:1.135
ISSN:1673-1727
年,卷(期):2024.39(2)
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