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李晓龙主任医师论治放射性肺炎经验

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放射性肺炎是食管癌、肺癌、乳腺癌、纵膈肿瘤或胸部恶性肿瘤等经放射治疗,在放射野内的正常肺组织受到射线损伤而引起的炎症反应,临床症状以刺激性咳嗽、咳痰,气短、心悸、胸痛、呼吸困难等为主,是放射线治疗恶性肿瘤的常见不良反应之一,严重影响患者的生活质量甚至生命安全.李晓龙主任医师认为本病的发生责之于外因,放射线具有直中脏腑、伤津耗气、损伤络脉的特点,可归属于外来火热毒邪范畴.李晓龙主任医师根据放射线的致病特点及在人体内的作用,认为"气、瘀、痰、毒"是本病的病理因素,气阴两虚为基本病机,病性为虚实夹杂,认为放射性肺炎病位在肺,与脾、胃、大肠等脏腑相关,其病情变化主要取决于患者的体质及放射治疗的面积、持续时间,因而在治疗上以健脾益肺、益气养阴为本,以化痰、祛瘀、解毒、理气为法,从整体观念出发,根据其病情的发展变化、病理因素的偏向,结合其正邪的动态消长,辨证施治,灵活用药,做到固本与清源的有机结合,从而达到治愈本病的目的.文章从放射线的特性入手,通过理论与实际案例的相互论证,总结李晓龙主任医师治疗放射性肺炎的经验,以期能更好地传承导师经验,为临床诊疗提供参考价值.
Chief physician LI Xiaolong's experience in treating radiation pneumonia
Radiation pneumonia is an inflammatory reaction caused by radiation damage to normal lung tissues in the radiation field after radiation treatment,such as esophageal cancer,lung cancer,breast cancer,mediastinal tumor or chest malignant tumor.Clinical symptoms are mainly irritating cough,sputum,shortness of breath,palpitations,chest pain,dyspnea,etc..It is one of the common side effects of radiation treatment for malignant tumors,and seriously affect patients's quality of life,even life safety.Chief physician LI Xiaolong believes that the occurrence of the disease is due to external causes,radiation has the characteristics of straight in the viscera,injury of fluid consumption,and damage to the choroid vein,and can be attributed to the category of external heat toxic evil.According to the pathogenic characteristics and effects in the human body of radiation,Chief physician LI Xiaolong believes that"Qi(气),stasis,phlegm and poison"are the pathological factors of the disease,the basic pathogenesis is Qi and Yin(阴)deficiency,and the disease is mixed with deficiency and insufficiency.Chief physician LI believes that radiation pneumonia is located in the lung and is related to the spleen,stomach,large intestine and other viscera,and the change of its condition mainly depends on the patient's physique and the area and duration of radiation treatment.Therefore,the treatment is mainly to strengthen spleen and lungs,and tonify Qi and Yin,so as to eliminate phlegm,remove blood stasis,detoxification,and regulate Qi.From the overall concept,according to the development of the disease,pathological factors,combined with the dynamic rise and fall of healthy Qi and evil,based on syndrome differentiation,drugs are used flexibly to achieve the organic combination of consolidation and Qingyuan(清源)to cure the disease.Starting with the characteristics of radiation,this paper summarizes the experience of Chief physician LI Xiaolong in the treatment of radiation pneumonia through the mutual demonstration of theory and practical cases,in order to better inherit the mentors's experience and provide reference value for clinical diagnosis and treatment.

RadiationRadiation pneumoniaTraditional Chinese medicineExperience

王娜娜、李晓龙、李海莲、文硕

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甘肃中医药大学,甘肃 兰州,730000

宁夏中医医院暨中医研究院,宁夏 银川,750000

放射线 放射性肺炎 中医药 经验

2024

中医临床研究
中华中医药学会

中医临床研究

影响因子:0.839
ISSN:1674-7860
年,卷(期):2024.16(8)
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