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[马桂琴教授治疗职业性尘肺病经验介绍]

[Introduction to Professor Ma Guiqin's experience in treatment of occupational pneumoconiosis].

作者信息

Wang Hai-Jian, Ma Gui-Qin

机构信息

Beijing Chemical Occupational Disease Prevention and Control Institute Beijing 100093,China.

Guang'anmen Hospital,China Academy of Chinese Medical Sciences Beijing 100053,China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2019 Jul;44(13):2871-2874. doi: 10.19540/j.cnki.cjcmm.20190419.502.

Abstract

Occupational pneumoconiosis refers to a group of occupational pulmonary diseases,which is mainly characterized by diffuse fibrosis of lung tissue caused by inhalation of different pathogenic productive dust and retention in the lungs during occupational activities for a long period of time. According to the classification and catalogue of occupational diseases in China,it is mainly classified into 12 categories,such as silicosis,coal worker's pneumoconiosis,asbestos lung. At present,it is the most serious and most common occupational disease in China. The pathogenesis of pneumoconiosis is not clear,and there is still no effective therapy. In the past three years,it is found that traditional Chinese medicine is effective in the treatment of pneumoconiosis. Through collection of medical records,the regularity of the prescriptions used in the treatment of pneumoconiosis were analyzed and summarized. According to the traditional Chinese medicine theory,the clinical characteristics of recurrent cough,phlegm and asthma in patients with pneumoconiosis could be included in the categories of cough,wheezing,lung distension. Professor Ma Guiqin believes that the basic pathogenesis of pneumoconiosis is depression of the atmosphere,deficiency of the kidney,internal obstruction of phlegm,and adverse cardinality. According to its pathogenesis,the commonly used prescriptions,namely Shengxian Decoction,Jinshui Liujun Jian,Xiaochaihu Decoction,Sini Powder,Guomin Jian and syndrome differentiation-based modified medicines were expounded. In addition, " throat is the gateway to the lung and stomach",Professor Ma also believes that the prevention of pneumoconiosis should start with the throat,so as to curb the exacerbation or recurrence of the disease. Through clinical observation,if traditional Chinese medicine is properly used,and pathogenesis and syndrome differentiation-based treatment is provided,traditional Chinese medicine can relieve the clinical symptoms,and improve the exercise tolerance and the quality of life of patients with pneumoconiosis.

摘要

职业性尘肺病是指一组职业性肺部疾病,主要特点是在职业活动中长期吸入不同致病性生产性粉尘并潴留于肺部,引起肺组织弥漫性纤维化。根据我国职业病分类和目录,主要分为矽肺、煤工尘肺、石棉肺等12类。目前是我国最严重、最常见的职业病。尘肺病的发病机制尚不明确,目前仍无有效治疗方法。近三年发现,中医药在尘肺病治疗中有效。通过收集病历,分析总结尘肺病治疗用药规律。根据中医理论,尘肺病患者反复咳嗽、咳痰、气喘的临床特点可归属于咳嗽、哮病、肺胀范畴。马贵琴教授认为,尘肺病的基本病机为大气下陷、肾虚、痰瘀内阻、肺失宣肃。根据其病机,阐述了常用方剂,即升陷汤、金水六君煎、小柴胡汤、四逆散、过敏煎及辨证加减用药。此外,“咽喉为肺胃之门户”,马教授还认为,尘肺病的预防应从咽喉入手,以遏制病情加重或复发。通过临床观察,合理运用中医药,辨证论治,可缓解尘肺病患者的临床症状,提高运动耐力和生活质量。

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