从瘀探讨肺间质纤维化中医病因病机

目的：从瘀探讨肺间质纤维化中医病因病机。方法：针对肺间质纤维化慢性病程、逐渐加重的疾病特点,提出了瘀血致病的观点。详细论述了内伤瘀血的产生机制,临床表现和致病特点。结果：脾失健运,痰湿内生,气机阻滞,肝失疏泄,气机不利,心气不足,推动无力,肺气不利,病及于血,五脏亏损,气血不复,久病入络皆可导致血瘀。瘀有显性表现和隐性指标,瘀的致病特点为起病缓慢,病情隐匿;病性复杂,兼夹他邪;瘀分显隐,共同致病;为害严重,伤人形质。结论：血瘀为肺间质纤维化发病的重要机制,临床诊治过程中应对血瘀加以重视。

Exploration on the TCM Etiology and Pathogenesis of Interstitial Pulmonary Fibrosis from the Perspective of Stasis

Objective：To explore the TCM etiology and pathogenesis of interstitial pulmonary fibrosis from the perspective of stasis.Methods：The view of pathopoiesia by blood stasis was proposed according to the characteristics of interstitial pulmonary fibrosis such as chronic course and gradual aggravation.The generation mechanism of blood stasisi due to internal injuries,clinical manifestations and pathogenic characteristics were discussed in detail.Results：Blood stasis could be caused by the failure of spleen in acitvation and transportation which lead to the endogenous phlegm and dampness,the obstruction of qi acitivity,the failure of liver to maintain the normal flow of qi,disorder of functional activities of qi,deficiency of heart qi,the asthenia of promoting function,unsmoothness of pulmonary qi which involved with the blood stage,the decrement of five zang-organs,the disharmony between qi and blood and the invasion of pathogens into collaterals in protracted disease.There were dominant performance and recessive indicators for stasis.The pathogenic characteristics of stasis were slow onset,occult illness,complex disease characteristics and involvement with other evils.The stasis can be both explicit and implicit which could lead to diseases together.It could cause serious damage and impair people′s form quality.Conclusion：The blood stasis is an important mechanism for the pathogenesis of interstitial pulmonary fibrosis,so it should be paid special attention in the clinical diagnosis and treatment.