1.北京中医药大学 北京 100029
2.北京中医药大学东方医院
3.北京中医药大学东直门医院
李瑞,男,在读硕士生
# 张晓梅,女,博士,教授,主任医师,博士生导师,主要研究方向:中医药防治呼吸系统疾病,E-mail:Zhangxim6767@sina.com
纸质出版日期:2023-06-30,
网络出版日期:2023-04-04,
收稿日期:2022-10-29,
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李瑞, 张晓梅, 李梦乾, 等. 基于三焦“四通膜性管道”探讨类风湿关节炎继发肺间质纤维化治疗[J]. 北京中医药大学学报, 2023,46(6):848-852.
LI Rui, ZHANG Xiaomei, LI Mengqian, et al. To explore the treatment of pulmonary interstitial fibrosis secondary to rheumatoid arthritis based on the concept of sanjiao "four-way membranous channels"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(6):848-852.
李瑞, 张晓梅, 李梦乾, 等. 基于三焦“四通膜性管道”探讨类风湿关节炎继发肺间质纤维化治疗[J]. 北京中医药大学学报, 2023,46(6):848-852. DOI: 10.3969/j.issn.1006-2157.2023.06.016.
LI Rui, ZHANG Xiaomei, LI Mengqian, et al. To explore the treatment of pulmonary interstitial fibrosis secondary to rheumatoid arthritis based on the concept of sanjiao "four-way membranous channels"[J]. Journal of Beijing University of Traditional Chinese Medicine, 2023,46(6):848-852. DOI: 10.3969/j.issn.1006-2157.2023.06.016.
三焦是包罗联系脏腑的膜系,内联脏腑微膜、外联肌肤筋骨关节,上下连接五脏六腑,为膜性四通管道,完成气机气化,促进水液运行,化生护卫精微。类风湿关节炎继发肺间质纤维化的中医病机为正气亏虚、三焦不利、痰瘀互结痹阻关节及肺微膜。初病感受风、寒、湿等外邪,蕴于筋骨关节,迁延日久化生痰浊瘀血,痹阻关节且内舍三焦膜性管道,流窜停滞肺微膜,发为肺间质纤维化。三焦“四通膜性管道”是关节痰瘀流窜肺脏的通路,三焦不利则加重痰浊瘀血停滞。临床治疗以“通、化、调”为原则疏利三焦,即选择理气活血祛风之通药、补肺温肾化气之化药,以调理脏腑状态,畅通三焦膜性管道,消散痹阻肺微膜之痰瘀浊邪。
Sanjiao
a term of traditional Chinese medicine
which consists of the upper
middle
and lower jiao
is a membrane system that encompasses the zangfu organs. We propose the idea that sanjiao is a four-way membranous channels
internally connecting with the micro-membrane of the zangfu organs
extending to the skin
muscles
tendons
bones
and joints
by which water and fluid is transferred from the upper jiao to the middle jiao
then to the lower jiao
countering the transfer of blood and essence to promote the qi movement and generate health-promoting nutrition. Pulmonary interstitial fibrosis secondary to rheumatoid arthritis is characterized by disorders of both joints and the lung
and it is a condition in which healthy qi deficiency occurs
with phlegm and blood or intertwined that blocks the joints and lung micro-membrane. In the early stage of rheumatoid arthritis
external evils
such as wind
cold
and damp
build up in the joints of the tendons and bones
and prolonged early-stage symptoms would cause phlegm production and blood stasis which may obstruct the joints. Phlegm turbidity and blood stasis remain in the sanjiao membranous channels and stagnate the pulmonary micro-membrane
which may cause the pulmonary interstitial disease. The sanjiao four-way membranous channels is the pathway for joint phlegm and blood stasis flowing to the lungs
and sanjiao obstruction can aggravate phlegm and blood stagnation. The treatment is based on the principle of dredging
transforming
and regulating sanjiao
selecting herbs for regulating qi
promoting blood circulation and expelling wind
and using drugs that tonify the lung
warm the kidney
turn to qi
and regulate the state of zangfu organ. This unblocks the sanjiao membranous channels and dissipates the phlegm and blood stasis turbidity evil of the obstructed lung micro-membrane
and it can effectively treat pulmonary interstitial fibrosis secondary to rheumatoid arthritis.
三焦膜性管道论类风湿关节炎继发肺间质纤维化肺微膜疏利三焦
the theory of sanjiao membranous channelsrheumatoid arthritissecondary pulmonary interstitial fibrosislung micro-membranedredging and regulating sanjiao
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