第31卷第9期2013年9月中华中医药学刊CHINESEARCHIVESOFTRADITIONALCHINESEMEDICINEVol．31No．9Sep．2013中华中医药2033学刊从脾胃论治肺胀马丽佳，徐洪洁，曲妮妮(辽宁中医药大学附属医院，辽宁沈阳110032)摘要:肺胀是多种慢性肺系疾患反复发作，迁延不愈，导致肺气胀满，不能敛降的一种病证。临床表现为胸部膨满、胀闷如塞、喘咳上气、痰多、烦躁等。其病程缠绵，症状时轻时重，日久可见面色晦黯，唇甲青紫，心悸，脘腹胀满，肢体浮肿，甚或喘脱等危重症状。是常见病、多发病、危重病。通过学习四大经典并结合临床实践，认为肺胀临床表现每多虚实互见，寒热夹杂，主脏在肺，并与脾、肾、心密切相关，脾虚贯穿肺胀整个病程。临床常见外寒内饮、外寒内热、肺脾气虚、肺肾气阴两虚、肺心气阴两虚、阳虚水泛、痰蒙神窍7个证型。治疗主张祛邪顾脾胃、固本健脾胃、健脾以安肺、脾、肾、心。即从脾胃论治肺胀。关键词:肺胀;脾胃;辨证;论治中图分类号:R256．1文献标志码:A文章编号:1673－7717(2013)09－2033－03StudyofTreatingLungDistensionConsideringConditionofSpleenandStomachMALijia，XUHongjie，QUNini(FirstAffiliatedHospitalofLiaoningUniversityofTraditionalChineseMedicine，Shenyang110032，Liaoning，China)Abstract:Lungdistensionisonetypeofpulmonarydiseasescausedbyrepeatedepisodesandpersistentunhealedva-riouschronicpulmonarydiseases，andthereforeperformsaslungfullnessandnotrelieving．Theclinicalmanifestationsoflungdistensionincludechestswelling，nausea，cough，phlegmandirritability．Thediseasecouldbelingeringandtheconditionfluctuates．Prolongedlungdistensionwouldleadtocriticalsymptoms，suchasdullcomplexion，bruisinglipsandfingernails，palpitations，abdominaldistension，swellingofthelimbsandasthma．Theaforementionedcharacteristicsindicatethatlungdistensioniscommon，frequentlyoccurringandcritical．Accordingtolearningofthefourclassicsandclinicalpractice，itisbelievedthattheclinicalmanifestationsoflungdistensionperformbothspirituallyandphysically，mixedwithbodycoldandheat．Lungisthemainlyinvolvedorgan，butcloselyrelatedtospleen，kidneyandheart．Par-ticularly，spleen－weakeningaccompaniesarethroughoutthelungdistension．AccordingtoTCM，theclinicalmanifesta-tionsoflungdistensionareexteriorcoldandinteriorfluidretention，exteriorcoldandinteriorheat，Qideficiencyinlungandspleen，deficiencyofbothQiandYininlungandkidney，deficiencyofbothQiandYininlungandheart，edemaduetoYangdeficiency，phlegm－blockedspiritandfeatures．Propertreatmentsforlungdistensionincludedispellingevilandstrengtheningspleenandstomach，foundationstrengtheningandrehabilitationofspleenandstomach，recoveringlung，spleen，kidneyandheartbystrengtheningspleen．Inshort，thetreatmentoflungdistensionwasstudiedconsider-ingtheconditionofspleenandstomach．Keywords:lungdistension;spleenandstomach;syndromedifferentiation;treatmentdetermination收稿日期:2013－04－22作者简介:马丽佳(1962－)，女，辽宁沈阳人，主任医师，学士，研究方向:中西医结合诊治呼吸系统疾病。肺胀是多种慢性肺系疾患反复发作，迁延不愈，导致肺气胀满，不能敛降的一种病证。临床表现为胸部膨满、胀闷如塞、喘咳上气、痰多、烦躁等。其病程缠绵，症状时轻时重，日久可见面色晦黯，唇甲青紫，心悸，脘腹胀满，肢体浮肿，甚或喘脱等危重症状。现代医学没有“肺胀”病名，肺胀证候特征主要见于慢性阻塞性肺疾病(COPD)和慢性肺源性心脏病(CPHD)。因本病为临床多发病和常见病，严重影响患者的身体健康和生活质量。笔者临证20余年，通过学习四大经典并结合临床实践，主张从脾胃论治肺胀，现阐述如下。1临床辨证探析肺胀临床表现每多虚实互见，寒热夹杂，主脏在肺，并与脾、肾、心密切相关，故临床表现复杂...
