陆家龙基于窠囊学说辨治慢性阻塞性肺疾病频繁急性加重的经验OA

[Objective]To summarize Professor Lu Jialong's clinical experience in treating frequent acute exacerbations of chronic obstructive pulmonary disease(COPD)based on the Ke-Nang theory.[Methods]Relevant literature on the concept of Ke-Nang was reviewed,and Professor Lu's clinical practice was analyzed to summarize his syndrome differentiation,treatment principles,treatment methods,and medication regimens,with supporting case reports.[Results]Inspired by the theory of Ke-Nang,Professor Lu proposes that the core pathogenesis of frequent acute exacerbations of COPD lies in spleen deficiency and impaired fluid metabolism as the root,with latent phlegm and blood stasis in the lung and Qi stagnation as the manifestation.Professor Lu develops the"strengthen the spleen to expel phlegm"method.In the acute stage,treatment focuses on resolving phlegm,eliminating turbidity,regulating Qi,and removing stasis to restore the ascending and descending movement of lung Qi;In the stable stage,treatment focuses on strengthening the spleen and tonifying the kidney to prevent the recurrence and accumulation of phlegm and stasis.In the attached case of lung distension,diagnosed as deficiency of middle Qi with fluid retention and blood stasis obstruction,modified Huangqi Jianzhong Decoction combined with Zhimi Fuling Pill was used at the first visit to resolve phlegm and remove stasis;modified Linggui Zhugan Decoction was used at the second visit to warm Yang and eliminate retained fluid;and the self-designed Chongpi Zhutan Powder was used at the third visit to strengthen the spleen,tonify the kidney and restore visceral function.Throughout the three-stage treatment,restoration of spleen and stomach transportation and transformation was taken as the core strategy,following the principle of"tonifying deficiency as the primary approach,supplemented by eliminating excess".As a result,vital Qi of the five Zang-viscera organs was gradually restored,phlegm-stasis was alleviated,the formation of Ke-Nang was inhibited,and the patient's condition improved.[Conclusion]Professor Lu Jialong's"strengthen the spleen to expel phlegm"method developed on the basis of the Ke-Nang theory,provides a theoretical basis and practical guidance for the traditional Chinese medicine(TCM)treatment of frequent acute exacerbations of COPD,and may serve as a useful reference for TCM intervention in this condition.