1.山东中医药大学中医学院 济南 250013
2.山东中医药大学附属医院
苏健,男,在读硕士生
#张伟,男,博士,主任医师,教授,博士生导师,主要研究方向:呼吸系统疾病中西医结合临床诊疗与基础理论的研究,E-mail:huxizhijia@126.com
纸质出版日期:2023-03-30,
网络出版日期:2022-12-30,
收稿日期:2022-09-23,
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苏健, 刘学, 张伟, 等. 基于脾胃浊毒理论辨治干燥综合征相关性间质性肺疾病[J]. 北京中医药大学学报, 2023,46(3):392-396.
SU Jian, LIU Xue, ZHANG Wei, et al. Differentiation and treatment of interstitial lung disease associated with Sjögren syndrome based on the theory of turbid poison of spleen and stomach[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(3):392-396.
苏健, 刘学, 张伟, 等. 基于脾胃浊毒理论辨治干燥综合征相关性间质性肺疾病[J]. 北京中医药大学学报, 2023,46(3):392-396. DOI: 10.3969/j.issn.1006-2157.2023.03.016.
SU Jian, LIU Xue, ZHANG Wei, et al. Differentiation and treatment of interstitial lung disease associated with Sjögren syndrome based on the theory of turbid poison of spleen and stomach[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(3):392-396. DOI: 10.3969/j.issn.1006-2157.2023.03.016.
干燥综合征相关性间质性肺疾病属于中医学“燥痹”范畴,一般认为其病机以内燥为核心,因先天禀赋不足或外感燥邪,使得燥热内生,灼伤津液而致病。水谷精微游溢滞缓,谷精积聚过多或运化异常皆可变生浊邪,而浊邪积聚是变生浊毒的基础。浊毒兼有毒邪之特性,其性峻烈,更易耗伤气血,具有胶着、黏滞、秽浊的特点。浊毒可归为一类本原之毒,其化毒原基为浊,浊自谷化,若谷精正化则为醇厚濡养之精华,异化则酿作腐秽之邪浊。脾虚生浊成毒是一个逐渐积蓄的过程,浊毒致病可损伤脏腑,且病性复杂,迁延易复。本团队认为,脾胃不足为生燥之源,浊毒挟痰瘀胶结于中焦及肺络是加重燥象的关键因素。脾胃浊毒贯穿本病始终,早期脾胃亏虚,浊邪初聚,碍气伤津;中期由浊酿毒,毒热迫蒸,痰瘀交结;晚期浊毒壅滞,癥瘕聚络,败坏诸脏。临床诊疗应根据浊毒化生程度,早期应阻截浊毒生成之源,重视顾护津液;中晚期应化浊解毒开通络脉,兼顾补虚以复正气。干燥综合征相关性间质性肺疾病的病证表现与浊毒侵犯人体的特点相一致,脾胃浊毒理论可为本病的中医辨治提供新思路。
Interstitial lung disease associated with Sjögren syndrome belongs to the category of "arthralgia caused by dryness pathogen" in traditional Chinese medicine
and it is generally believed that its pathogenesis is centered on internal dryness
which is caused by internal heat and burning of body fluid due to the lack of innate endowment or external dryness. The metabolism of water and grain essence is slow
and excessive accumulation of grain essence or abnormal transportation and transformation can lead to turbidity
and the accumulation of turbidity is the basis for the development of turbid poison. Turbid poison has the characteristics of poisonous evil
its nature is harsh
it is more likely to consume qi and blood
and it has the characteristics of agglutination
stagnation and filth. Turbid poison can be classified as a class of original poison. The original base of its transformation is turbidity from the grain essence. If the grain essence is transformed into a mellow and moist essence
alienation is brewed into the turbidity of corruption. The formation of turbid poison caused by spleen deficiency is a process of gradual accumulation
which can damage the internal organs and is complex and easily recurring. We believe that deficiency of the spleen and stomach is the source of dryness and that turbid poison with phlegm and blood stasis in the middle jiao and lung channels is the key factor aggravating the dryness. The theory of turbid poison of spleen and stomach covers the whole disease process. In the early stage
the spleen and stomach are deficient and the turbidity gathers at the beginning
which hinders qi and injures body fluid. In the middle stage
the turbidity breeds turbid poison
which leads to heat with phlegm and blood stasis. In the late stage
the turbid poison accumulates to form a mass
which can damage various organs. Clinical treatment should be based on the degree of turbid poison
blocking the source of turbid poison in the early stage
paying attention to the protection of body fluid
dredging the meridians by detoxification in the middle and late stage and taking in energy to restore the vital qi. The symptoms and signs of interstitial lung disease associated with Sjögren syndrome are consistent with the characteristics of turbid poison invading the human body. The theory of turbid poison of spleen and stomach can provide a new idea for the differentiation and treatment of this disease in traditional Chinese medicine.
干燥综合征脾胃亏虚浊毒间质性肺疾病
Sjögren syndromedeficiency of spleen and stomachturbid poisoninterstitial lung disease
SHIBOSKI CH,SHIBOSKI SC,SEROR R, et al. 2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjögren's Syndrome:A Consensus and Data-Driven Methodology Involving Three International Patient Cohorts [J]. Arthritis Rheumatol, 2017, 69(1):35-45.
ANAYA JM,ROJAS-VILLARRAGE A,MANTILLA RD, et al. Polyautoimmunity in Sjögren syndrome [J]. Rheum Dis Clin North Am, 2016, 42(3): 457-472.
FLAMENT T,BIGOT A,CHAIGNE B, et al. Pulmonary manifestations of Sjogren’s syndrome [J]. Eur Respir Rev, 2016, 25(140):110-123.
邢玉瑞.中医浊毒概念问题探讨[J].中医杂志,2017,58(14):1171-1174.
孙建慧,杨倩,刘阳,等.构建中医浊毒理论体系框架的思考[J].中医杂志,2020,61(8):660-663.
常富业,张允岭,王永炎,等.毒的概念诠释[J].中华中医药学刊,2008,26(9):1897-1899.
吴深涛.内毒辨释[J].上海中医药杂志,2014,48(2):4-7.
吴深涛,王斌,章清华,等.论糖尿病从“脾不散精”到“浊毒内蕴”之病机观[J].中医杂志,2018,59(22):1920-1924.
杨倩,才艳茹,刘建平,等.李佃贵教授从浊毒论治慢性萎缩性胃炎用药规律分析[J].时珍国医国药,2016,27(9):2270-2271.
孙建慧,杨倩,张纨,等.脾虚浊毒论[J].北京中医药大学学报,2021,44(9):812-817.
陈凤,林琪明,张伟.基于“皮部-经络-脏腑”论治干燥综合征相关性间质性肺疾病[J].中国中医基础医学杂志,2021,27(9):1501-1504.
BISWAS SK,RAHMAN I.Environmental toxicity,redox signaling and lung inflammation: the role of glutathione[J].Mol Aspects Med,2009,30(1) : 60-76.
焦以庆,王玉光,郭丽娅,等.干燥综合征继发肺间质疾病45例的中西医临床特点分析[J].中华中医药杂志,2020,35(2):876-879.
张川锋,王振兴,杨昆,等.试论浊邪与肺纤维化疾病[J].中国中医基础医学杂志,2018,24(4):438-440.
杨帆,张伟.基于玄府-肺络新视点探讨干燥综合征相关性间质性肺疾病的中医病机演变[J].中华中医药杂志,2019,34(7):2935-2938.
BOTH T,DALM VA,VAN HAGEN PM, et al. Reviewing primary Sjögren's syndrome: beyond the dryness - from pathophysiology to diagnosis and treatment[J]. Int J Med Sci, 2017, 14(3): 191-200.
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