基于“态靶辨证”分析扶正通络方治疗肺间质纤维化

"态靶辨证"是由仝小林院士基于中医的"调态"及现代药理学研究发展而提出的临床新思路,主张将中医的"宏观辨证"与西医的"微观辨病"相互贯通。张炜主任辨治肺系疾病时,以络病理论为指导,辨证围绕"虚瘀合邪,肺气络伤",认为病之初感以"痹"之"瘀态"为主,治以通痹之法;久之以"痿"之"虚态"为要,治以益气养阴为主。但多痹痿并存,呈虚实错杂之"虚瘀合邪"之态。针对肺间质纤维化"虚瘀合邪"之态,临证时,多采用张炜主任的扶正通络方,方由生地黄、山茱萸、女贞子、怀牛膝、菟丝子、五味子、蛤蚧、橘络、丝瓜络、三七粉组成,全方遵"补虚通络"之旨,"调补兼施,寓治于补,寓补于通",收效显著。

An Analysis of Formula for Reinforcing the Healthy Qi and Dredging Meridians in the Treatment of Pulmonary Interstitial Fibrosis Based on"State Target Syndrome Differentiation"

"State target syndrome differentiation"is a new clinical idea put forward by academician Tong Xiao-lin based on the"state modulation"of TCM and the research and development of modern pharmacology.It advocates connecting the"macro syndrome differentiation"of TCM with the"micro disease differentiation"of Western medicine.When treating lung diseases,Zhang Wei takes the collateral disease theory as the guidance,focuses on"combination of deficiency and blood stasis,lung qi collateral injury",and thinks that the initial state of the disease is mainly the"blood stasis state"of"arthralgia",and the treatment should focus on dredging arthralgia.For a long time,the"deficient state"of"flaccidity"is the key,and the treatment is mainly to replenish qi and nourish yin.However,in most cases,arthralgia and flaccidity coexist,showing the state of"combination of deficiency and blood stasis".In view of the"combination of deficiency and blood stasis"state of pulmonary interstitial fibrosis,Director Zhang Wei mostly adopts Formula for Reinforcing the Healthy Qi and Dredging Meridians,which is composed of Shengdihuang(Radix Rehmanniae),Shanzhuyu(Fructus Corni),Nyuzhenzi(Fructus Ligustri Lucidi),Huainiuxi(Radix Achyranthis Bidentatae),Tusizi(Semen Cuscutae),Wuweizi(Fructus Schisandrae Chinensis),Gejie(Gecko),Juluo(Vascular Aurantii),Sigualuo(Retinervus Luffae Fructus)and powder of Sanqi(Radix et Rhizoma Notoginseng).The whole formula follows the purpose of"tonifying deficiency and dredging collaterals",and"regulating and tonifying together for dredging",and has achieved remarkable results.