国医大师王晞星基于"肝升肺降"理论运用小柴胡汤分级治疗肺结节经验探析OA
Analysis of Wang Xixing's experience in grading treatment of pulmonary nodules using Xiaochaihu Decoction based on the"liver ascending and lung descending"theory
肺结节(PN)是影像学表现为直径≤3 cm的局灶性、类圆形、密度增高的实性或亚实性肺部阴影,归属中医学"肺积""咳嗽""咳喘"等范畴.目前,PN检出率已达到50.9%,其中恶性结节约占4%.在我国,肺癌的发病率与病死率均居恶性肿瘤首位,因此,早期开展PN的筛查与临床干预,在肺癌防治中具有重要意义.国医大师王晞星基于中医学"肝升肺降"气机理论,认为肝升肺降失用是PN发生、发展的核心病机,肝郁肺闭致气滞初起,进而痰瘀互结,推动结节由低中危向高危进展;主张从"升肝降肺"的角度升降气机,化消结节.王晞星教授以经方小柴胡汤为基础方,贯穿全程,发挥其调和肝肺、枢转气机的作用;加减经方以调气散结治疗低中危结节,配伍对药以活血化痰治疗高危结节,并强调内外同治、神形同调,以舒畅气机.通过系统总结王晞星教授基于"肝升肺降"理论分级论治PN的学术思想与临证经验,并附医案佐证,以彰显其理论创新与临床实效,为PN的中医精准防治提供了重要参考.
Pulmonary nodules(PN),radiologically manifested as focal,roundish,and high-density solid or subsolid lung shadows with a diameter≤3 cm,are categorized in Traditional Chinese Medicine(TCM)under"lung accumulation","cough"and"wheezing cough".Currently,the detection rate of PN has reached 50.9%,with malignant nodules accounting for approximately 4%.In China,the incidence and mortality rates of lung cancer rank first among malignant tumors,making early screening and clinical intervention for PN crucial in lung cancer prevention and treatment.Based on the TCM theory of"liver ascending and lung descending"in Qi Activity,Master of TCM Wang Xixing posits that dysfunction in liver ascending and lung descending is the core pathogenesis of PN occurrence and progression.Liver depression and lung obstruction lead to initial Qi stagnation,which further evolves into phlegm-stasis intermingling,driving the progression of nodules from low-to intermediate-risk and eventually to high-risk.He advocates regulating Qi activity from the perspective of"ascending the liver and descending the lung"to resolve nodules.Professor Wang Xixing uses the classical formula Xiaochaihu Decoction as the foundational prescription throughout the treatment process,leveraging its function to harmonize the liver and lung and pivot Qi activity.For low-to intermediate-risk nodules,modified classical formulas are employed to regulate Qi and dissi-pate nodules,while paired herbs are used to invigorate blood and resolve phlegm for high-risk nodules.He emphasizes si-multaneous internal and external treatment,as well as harmonizing the spirit and body,to promote the free flow of Qi.By sys-tematically summarizing Prof.Wang Xixing's academic thought and clinical experience in grading the treatment of PN based on the"liver ascending and lung descending"theory,supplemented with one medical case evidence,this study highlights his theoretical innovation and clinical efficacy,providing important references for the precise TCM prevention and treatment of PN.
刘懿婵;任少键;高宇;杨晓昆;房致永;王晞星
山西中医药大学,山西 太原 030024山西省中医院,山西 太原 030012山西省中医院,山西 太原 030012山西中医药大学,山西 太原 030024山西省中医院,山西 太原 030012山西省中医院,山西 太原 030012
医药卫生
肝升肺降肺结节王晞星名医经验
liver ascending and lung descendingPNWang Xixingfamous physician's experience
《山西中医药大学学报》 2026 (4)
384-389,395,7
第四届国医大师传承工作室(国中医药办人教函[2022]245号1123-04)国家中医药传承创新中心的建设(202203)国家中医临床研究基地(山西省中医院)专项任务书(JDZXLC-01)山西省卫健委山西省医学科技创新团队项目(2020TD04)山西省中医药研究院院内项目(202306)
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