胡国俊辨治支气管扩张症经验

胡国俊认为支气管扩张症的病位在肺,涉及肝、脾胃、肾多脏,在肺多为痰热久蕴,气阴两虚,治法以补益气阴、清化痰热,临床多用苇茎汤、葶苈大枣泻肺汤合生脉散加减;在肝多为情志怫郁,化火上扰,以疏肝解郁、清化痰热为治疗大法,常予四逆散、黛蛤散及柴胡羚角汤化裁;在脾胃多为脾胃失健,痰饮上渍,气阳偏虚,治法以补脾益气、益肺化痰,常选六君子汤、二陈汤、补中益气汤化裁;若气阴不足,治法以益气润土、滋养肺胃,方用六神散、沙参麦冬汤、生脉散化裁;在肾多为火炎烁金,肺络受损,此类患者注重滋阴壮水、补肾泻火,常用六味地黄汤、大补阴丸、二至丸合方。临床以痰热久蕴、气阴两虚型最多见。

HU Guojun's Experience in Treating Bronchiectasis

HU Guojun believed that the pathogenic locations of bronchiectasis were in the lung,involving the liver,spleen and stomach,kidney and other organs. The pathogenesis in the lung was phlegm and heat resulting in Qi and Yin deficiency after lingering for a long time which might be treated by replenishing Qi and Yin,clearing heat and phlegm. In clinic,Weijing decoction and Tingli Dazao Xiefei decoction combined with Shengmai powde were often used by adding or subtracting. The pathogenesis in the liver was the depression transforming into fire which might be treated by dispersing liver Qi stagnation and clearing away heat and phlegm. Sini powder and Daige powders,Chaihu Lingjiao decoction were often used by adding or subtracting. The pathogenesis in the spleen and stomach was its dysfunction of the spleen and stomach causing phlegm and fluid retention. Liujunzi decoction,Erchen decoction,Buzhong Yiqi decoction were used by adding or subtracting to invigorate the spleen Qi,reinforce the lung Qi and eliminate phlegm for Qi and Yang deficiency. Liushen powder,Shashen Maidong decoction and Shengmai powder were used by adding or subtracting to replenish Qi,nourish the spleen,lungs and stomach for Qi and Yin deficiency. The pathogenesis in the kidneys was fire affecting the lungs and impairing the pulmonary functions. Liuwei Dihuang decoction,Dabuyin pills,Erzhi pills were used by adding or subtracting to nourish kidney Yin and reduce fire.Phlegm and heat lingering for a long time and Qi and Yin deficiency were the most common pathogeneses.