摘要
特发性肺纤维化(IPF)是肺部的终末期疾病,其发病机制和病机演变过程复杂,与上皮间质转化(EMT)密切相关。本文在“虚气留滞”理论指导下,从中西医角度阐述IPF、“虚气留滞”和EMT三者之间关系,认为“虚气留滞”为IPF宏观病机,EMT为IPF微观机制。宏观病机上概括了IPF的发生发展过程,高度凝练IPF以“虚气”为本,“流滞”为标,因虚“流滞”的基本病机特点,以及“因虚生滞、由滞致虚”恶性循环的病机发展特点;微观机制上以抑制EMT为治疗靶点,防止上皮细胞损伤和凋亡,从而减少炎症因子、促纤维化因子等释放以避免损伤肺组织,以及受损的上皮细胞转化为成纤维细胞并产生大量细胞外基质沉积。基于“虚气留滞”理论,应以补虚、通滞为法,补虚包括补肺气、益气养阴、金水相生等,通滞包括行气活血、化痰燥湿、祛瘀通络等,临床运用应注意补虚与通滞并用。
Idiopathic pulmonary fibrosis(IPF)is a terminal disease of the lung.Its pathogenesis mechanism and pathogenesis evolution are very complex,which is closely related to epithelial-mesenchymal transformation(EMT).Under the guidance of the theory of"deficient-qi induced stagnation",this article elaborated on the relationship between IPF,"deficient-qi induced stagnation",and EMT from the perspective of TCM and Western medicine.It is believed that"deficient-qi induced stagnation"is the macroscopic pathogenesis of IPF,and EMT is the microscopic mechanism of IPF.The micro-mechanism was to inhibit EMT as the treatment target to prevent epithelial cell injury and apoptosis,thus reducing the release of inflammatory factors,pro-fibrosis factors and other factors that damage lung tissue and the transformation of damaged epithelial cells into fibroblasts and produce a large number of ECM deposition;the occurrence and development process of IPF was summarized in the macro pathogenesis.It was highly condensed that IPF was based on"deficiency-qi","stagnation"as the standard,and the basic pathogenesis characteristics of"stagnation"due to deficiency,as well as the pathogenesis development characteristics of the vicious cycle of"deficiency leads to stagnation,and from stagnation to deficiency".Based on the theory of"deficient-qi induced stagnation",it should be used to tonify deficiency and clear stagnation;tonifying deficiency includes replenishing lung qi,benefiting qi and nourishing yin,and mutual generation between metal and water;clearing stagnation includes circulating qi and blood,drying the wetness and eliminating phlegm,and promoting blood circulation for removing obstruction in collaterals,etc.In clinical application,attention should be paid to the fact that tonifying deficiency and clearing stagnation should be used in parallel.
作者
叶远航
罗成
宁博
阚竞
Ye Yuanhang;Luo Cheng;Ning Bo;Kan Jing(College of Traditional Chinese Medicine,Hubei University of Chinese Medicine,Wuhan 430060,China;The First Clinical College of Medicine,Shaanxi University of Chinese Medicine,Xianyang 712000,China;Hubei Hospital of Traditional Chinese Medicine,Affiliated Hospital of Hubei University of Chinese Medicine,Hubei Academy of Traditional Chinese Medicine,Wuhan 430074,China)
出处
《国际中医中药杂志》
2024年第12期1543-1548,共6页
International Journal of Traditional Chinese Medicine
基金
国家中医药管理局传承工作室建设项目(国中医药办人教函〔2022〕245号)。
关键词
肺疾病
间质性
上皮间质转化
虚气留滞
中医基础理论
Pulmonary disease,idiopathic
Epithelial to mesenchymal transition
Deficient-qi induced stagnation
Basic theory of Traditional Chinese Medicine
