从"邪伏肺络,微型癥瘕"视角动态解析儿童感染后闭塞性细支气管炎的微观病理及分期防治OA

The incidence of post-infectious occlusive bronchiolitis obliterans(PIBO)in children has recently increased significantly.Infection is the primary cause of occlusive BO in children,and its pathogenesis is linked to inflammation and an abnormal immune response.Fibrous proliferatior caused by abnormal tissue repair is the main histo pathological feature of BO.The dynamic pathological evolution of PIBO is characterized by an early stage of severe pneumonia and acute lung injury,followed by a mid-stage of abnormal secretion and repair disorders,and ultimately,a late stage of fibrosis and scar formation.In this paper,based on the theory of lung collaterals,the dynamic pathological evolution of PIBO in children is explained from the perspective of"pathogen hiding in lung collaterals,micro zheng jia,"in which pathogenic qi hides in the lung collaterals and the positive qi cannot expel it.The positive qi weakens as the disease course prolongs,and continues to injure the lung collaterals,ultimately leading to pulmonary fibrosis.The core pathogenesis of pulmonary fibrosis of PIBO in children is that"pathogen hiding in lung collaterals,"and"micro zheng jia"is the microscopic pathology of lung fibrosis in TCM.The treatment should be based on the general principle of"driving away pathogen and dredging collaterals,"which includes clearing heat and removing toxins,resolving phlegm and depression,and flowing qi and smoothing the collaterals at an early stage.Durry the middle stage,activating the blood and removing phlegm,clearing residual heat,and opening the collaterals should be focused.In the late stage,qi is promoted and yin and quyuchencuo are nourished while moistening the lungs and nourishing the collaterals to alleviate pulmonary fibrosis.Elaboration of the theory of"pathogen hiding in lung collaterals,micro zheng jia"can help improve the system of syndrome differentiation and treatment of lung collateral disease and provide novel insights for the clinical prevention and treatment of children's"severe pneumonia-PIBO"in traditional Chinese medicine.