Discussing the Staged Treatment of Progressive Fibrosing Interstitial Lung Disease Based on the Theory of"Opening-Closing-Pivoting"
Progressive fibrosing interstitial lung disease(PF-ILD)has a complex etiology,and is classified as lung impediment stage,impediment-atrophy combination stage,and lung atrophy stage according to the different clini-cal manifestations during the progression of disease.Based on the theory of opening-closing-pivoting to analyse the characteristics of yin and yang disease mechanism and the idea of prescriptions in the three stages.For lung impedi-ment stage,main as three-Yang fail to keep inside,disharmony between Ying qi(营气)and Wei qi(卫气),shaoyin impairment,treatment should use Mahuang(Ephedra sinica)and Guizhi(Neolitsea cassia)flexibly to form a formula,or choose pungent-dispersing formulas like Baidu Powder(败毒散)to move qi and save yang,and diffuse and dis-perse impediment pathogen,meanwhile combining saving-shaoyin medicinals like Fuzi(Aconitum carmichaelii)and Shudihuang(Radix Rehmanniae Praeparata)to reinforce healthy qi and dispel pathogen;for impediment-atrophy combination stage,rooted as yangming impairment and progressed by over-movement of qi,treatment should use Mahuang Shengma Decoction(麻黄升麻汤)to resolve and decrease over-activities,emphasis on both opening and closing,and improve impediment and atrophy;for lung atrophy stage with three-Yin in a bad condition simultaneously and poor prognosis,treatment should use modified Jinshui Liujun Decoction(金水六君煎)to consolidate qi and save yin,disperse phlegm and stasis,to improve the quality of life for patients with PF-ILD.
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