肺结节中西医治疗探讨

近年来肺结节发病率持续升高,逐渐得到人们关注,其病因和发病机制尚不明确。西医认为肺结节的发病主要与性别、年龄、主动或被动吸烟、遗传、环境和职业、工作及生活压力、接触有毒有害物质、气道菌群状态失调等有关,治疗上以胸部电子计算机断层扫描（CT）随访、局部热消融、糖皮质激素、手术切除等为主。中医认为肺结节多由禀赋不足、饮食失宜、情志内伤、体质及环境等因素导致,患者大多正气亏虚,且痰、瘀、毒等病理因素相互搏结,痹阻于肺络,从而发病。治疗上以温阳、益气、补益脾肺、祛痰、化瘀、解毒、行气解郁、软坚散结等治法为主。中医、西医在治疗肺结节方面各有优势,临床上应取长补短,采用中西医结合治疗。文章分别从中西医方向进行肺结节的诊疗汇总、分析,以期为肺结节的治疗提供新思路、新方向。

Discussion of traditional Chinese medicine and Western medicine treatment of pulmonary nodules

The gradually increasing incidence of pulmonary nodules has attracted considerable attention over the last few years.The etiology and pathogenesis of this disease are still unclear. Western medicine believes that the causes of pulmonary nodules are mainly related to gender,age,active/passive smoking,genetics,environment and occupation, work and life stress,exposure to toxic and harmful substances,airway flora status,etc. The treatment is based on chest CT follow-up,local thermal ablation,glucocorticoids,and surgical resection. Traditional Chinese medicine thinks that lung nodules are mostly caused by deficient endowment,improper diet,emotional internal injuries, physique and environment,etc. The pathogenesis is deficiency of righteousness,and obstruction of phlegm,stasis and toxin in the lung collaterals. The treatment is based on wenyang,tonifying qi,benefit the spleen and lung, expectorant,dispersing blood stasis,detoxification,regulating qi and alleviating depression,and dissipating mass. Chinese and Western medicine have their own advantages in the treatment of pulmonary nodules. Clinically,they should complement each other and be treated in integrative medicine. This paper summarizes and analyzes the treatment of pulmonary nodules in the direction of Chinese and Western medicine,respectively,in order to provide new ideas and directions for the treatment of pulmonary nodules.