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谢纬治疗肺结节切除术后咳嗽经验

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肺结节切除术后并发症以咳嗽较为常见,病机复杂。谢纬通过多年肺结节门诊临床实践,总结出肺结节切除术后咳嗽常见3种证型,即寒饮伏肺型、痰瘀阻肺型及气阴两虚型,分别以小青龙汤、涤痰汤合三拗汤及小柴胡汤、益气养阴方辨证加减施治。谢纬认为,在治疗过程中应基于标本兼治、扶正祛邪治则,需谨记手术易耗伤气阴,在治疗过程中应注意气阴亏损,适当加入黄芪、党参、太子参、五指毛桃、麦冬等补益气阴;需注意术后痰瘀毒邪仍未尽,在顾护气阴同时可加用当归、川芎、胆南星、浙贝母、猫爪草、夏枯草、醋鳖甲、牡蛎、石见穿等祛瘀化痰散结之品;还需重视对患者情志及睡眠的调治,可加用黄连、肉桂、龙骨、牡蛎、合欢花等安神之品。方无定方,当辨证施治,随证加减,可获佳效。
Exploration on Xie Wei's Experience in Treating Cough after Pulmonary Nodule Resection
Cough is a common complication after pulmonary nodule resection,and the pathogenesis is complex.Through years of clinical practice in the outpatient clinic of pulmonary nodules,Xie Wei summarizes three common syndromes of cough after pulmonary nodule resection,namely,cold fluid in the lung,phlegm and blood stasis obstructing the lung,and qi and yin deficiency.They are treated with Xiaoqinglong Decoction,Ditan Decoction and Sanao Decoction,Xiaochaihu Decoction and Yiqi Yangyin Decoction,modified with syndrome differentiation.Professor Xie believes that in the course of treatment,it should be based on the principle of treating both symptoms and root causes,strengthening the body resistance and eliminating pathogenic factors.It is necessary to keep in mind that the operation is easy to damage qi and yin.In the course of treatment,attention should be paid to the loss of qi and yin,and appropriate addition of Astragali Radix,Codonopsis Radix,Pseudostellariae Radix,Fici Hirtae Radix,Ophiopogonis Radix and other medicines with the efficacy of tonifying qi and yin.It is necessary to pay attention to the fact that the phlegm,blood stasis and toxin pathogens are still not exhausted after operation.At the same time of protecting qi and yin,Angelicae Sinensis Radix,Chuanxiong Rhizoma,Arisaema cum Bile,Fritillariae Thunbergii Bulbus,Ranunculi Ternati Radix,Prunellae Spica,Trionycis Carapax,Ostreae Concha,Salviae Chinensis Herba and other products for removing blood stasis,resolving phlegm and resolving masses can be added.It is also necessary to pay attention to the treatment of patients'emotional and sleep factors.Coptidis Rhizoma,Cinnamomi Cortex,Os Draconis,Ostreae Concha,Albiziae Flos and other tranquilizers can be added.There is no fixed prescription.When the disease is treated according to syndrome differentiation,the addition and subtraction with the syndrome can achieve good results.

pulmonary nodule resectioncoughTCM therapyXie Weiexperience of famous doctors

温智渊、杨林、陈珠妮、叶景焕、谢纬

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广州中医药大学第四临床医学院,广东 深圳 518033

深圳市中医院,广东 深圳 518033

肺结节切除术 咳嗽 中医药疗法 谢纬 名医经验

广东省中医药局科研项目深圳市科技创新专项深圳市医疗卫生三名工程项目

20222201JSGG20220226090002003SZSM201812063

2024

中国中医药图书情报杂志
中国中医科学院中医药信息研究所

中国中医药图书情报杂志

影响因子:0.556
ISSN:2095-5707
年,卷(期):2024.48(5)