| 引用本文:罗成1，叶远航2，宁博3，王飞1，4.基于“壮火食气”探讨支气管扩张症的病机与治疗思路[J].世界中医药,2024,(23):. |
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| 基于“壮火食气”探讨支气管扩张症的病机与治疗思路 |
| Pathogenesis and Treatment of Bronchiectasis Based on “Strong Fire Consumes Qi” |
| 投稿时间：2024-01-03 |
| DOI：10.3969/j.issn.1673-7202.2024.23.018 |
| 中文关键词: 支气管扩张症 壮火食气 病机 治疗思路 中医药 黄帝内经 壮火 肺络 |
| English Keywords:Bronchiectasis Strong fire consumes qi Pathogenesis Treatment idea Traditional Chinese medicine Huangdi's Internal Classic Strong fire Lung collateral |
| 基金项目:国家重点研发计划项目（2020YFC2003104）；国家自然科学基金面上项目（82174347）；四川省科技创新苗子工程培育项目（MZGC20230053） |
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| 中文摘要: |
| 支气管扩张症（BE）是以支气管出现不可逆的永久性异常扩张为特征的慢性进行性呼吸系统疾病。因此阻断支气管的异常扩张具有重要意义。基于“壮火食气”理论，从中西医角度、微观与宏观相结合方面阐述BE不同时期的病机。正气不足，“壮火”内盛，阻络损络，消“食”正气是BE急性期的主要病机特点，以“壮火”炽盛为其主要环节；“食气”气日久，“壮火”潜藏，络虚络损，暗“食”正气是BE稳定期的主要病机，以“食气”日久为其主要环节。治疗上确立了清“壮火”、补“虚气”的总治则，但“壮火”不可孤清，“虚气”不可独补，扶正祛邪并用。急性期以“壮火”为主，治标为要，应以清“壮火”兼以补“虚气”，同时注意辨证，根据邪气的偏重辅以相应的治法以提高临床疗效，同时注重肺之生理特性；稳定期以“食气”为主，治本为先，补“虚气”辅以清“壮火”，以防“壮火”复燃，同时注重通络药的使用，搜剔肺络中潜藏之“壮火”。 |
| English Summary: |
| Bronchiectasis(BE) is a chronic，progressive respiratory disease characterized by irreversible，permanent dilation of the bronchi.Therefore，blocking abnormal bronchial dilation is of significant importance.Based on the theory of “strong fire consumes qi”，this article discusses the pathogenesis of BE during different stages from both traditional Chinese medicine(TCM) and Western medical perspectives，combining microscopic and macroscopic viewpoints.In the acute phase of BE，the main pathological features are deficiency of healthy qi，an internal excess of “strong fire”，which obstructs and damages the collaterals，leading to the consumption of healthy qi.The core of this stage is the excessive “strong fire”.In the stable phase of BE，prolonged consumption of qi leads to hidden “strong fire” and the deficiency and damage of the collaterals，resulting in the subtle consumption of healthy qi.The main feature of this stage is the prolonged consumption of qi.Treatment should focus on clearing “strong fire” and supplementing “deficient qi” as a general approach.However，“strong fire” should not be cleared in isolation，nor should “deficient qi” be supplemented alone.Both supporting and expelling methods must be used in combination.During the acute phase，the focus is on the excess “strong fire”，and symptomatic treatment should prioritize clearing “strong fire” while supplementing “deficient qi”，with attention to syndrome differentiation.The appropriate treatment method should be tailored based on the predominant pathogenic factor to improve clinical efficacy，while considering the physiological characteristics of the lungs.In the stable phase，the emphasis is on “consumed qi”，and the primary treatment goal is to address the root cause.This involves supplementing “deficient qi” while clearing “strong fire” to prevent its recurrence，with the use of collateral-dredging drugs to target hidden “strong fire” in the lung collaterals. |
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