益气活血化瘀通络法治疗间质性肺疾病一例
One Case of Interstitial Lung Disease Treated by Invigorating Qi, Promoting Blood Circulation, Removing Stasis, and Dredging Collaterals
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1.浙江中医药大学附属第一医院呼吸科,浙江,杭州 310000
2.浙江中医药大学第一临床医学院,浙江, 杭州 310053
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杨珺超, 胡家铭. 益气活血化瘀通络法治疗间质性肺疾病一例[DB/OL].(2023-03-03)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=35103523&Fpath=home&index=0
YANG Junchao, HU Jiaming. One Case of Interstitial Lung Disease Treated by Invigorating Qi, Promoting Blood Circulation, Removing Stasis, and Dredging Collaterals[DB/OL].(2023-03-03)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=35103523&Fpath=home&index=0
杨珺超, 胡家铭. 益气活血化瘀通络法治疗间质性肺疾病一例[DB/OL].(2023-03-03)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=35103523&Fpath=home&index=0 DOI:
YANG Junchao, HU Jiaming. One Case of Interstitial Lung Disease Treated by Invigorating Qi, Promoting Blood Circulation, Removing Stasis, and Dredging Collaterals[DB/OL].(2023-03-03)[2023-11-05].http://cccl-tcm.cacm.org.cn/thesisDetails?columnId=35103523&Fpath=home&index=0 DOI:
病史摘要,2,患者,男,54岁,2020年7月14日因“活动后气急6年,加重1年”就诊。6年前患者无明显诱因下出现爬3层楼梯后气急,胸部CT扫描提示“肺气肿、肺大疱、两肺下叶间质性改变”,先后予噻托溴铵、布地奈德、福莫特罗吸入治疗后,症状仍逐渐加重。1年前患者快步走时即有气急,血气分析提示I型呼吸衰竭,肺功能检查提示弥散功能重度减退,予强的松15 mg/d口服3个月,乌美溴铵、维兰特罗吸入治疗,症状未见明显缓解。四诊信息:患者活动后气急明显,快步走、爬2层楼梯气急明显,口唇紫暗,爪甲青紫,杵状指明显。无咳嗽、咳痰,无发热恶寒。纳寐一般,二便无殊。舌体正常,舌质淡红,苔薄白,舌中部舌苔剥脱,脉细数。中医诊断 肺痿病(气虚血瘀证)西医诊断 间质性肺疾病干预措施 中医药治以益气活血,化瘀通络,予血府逐瘀汤合四君子汤加减,西药予吡非尼酮、强的松、泮托拉唑、乙酰半胱氨酸治疗。疗效转归 患者活动后呼吸困难症状缓解,肺弥散功能略有好转。
Summary of case history, The patient, male, 54 years old, was admitted to the hospital on July 14, 2020 due to "post-activity shortness of breath for 6 years and aggravation for 1 year". Six years ago, the patient developed shortness of breath after exercise (such as climbing three flights of stairs) without obvious inducement, and chest computed tomography (CT) showed "emphysema, bullae of lung, interstitial changes of lower lobes of two lungs". Tiotropium, budesonide, and formoterol were given through inhalation therapy, but the symptoms gradually worsened. One year ago, the patient had severe shortness of breath after exercise, which was manifested as shortness of breath during brisk walking. Blood gas analysis suggested type I respiratory failure, and pulmonary function examination suggested severe decline in diffusion function. The patient was treated with oral prednisone 15mg/d for 3 months, urmepium bromide and verranterol inhalation, but no significant relief of symptoms was found.,Symptoms and signs, The patient had obvious shortness of breath after the activity, such as brisk walking and climbing two flights of stairs. The patient had dark purple lips, purple claws, and obvious clubbing fingers. The patient had no cough, fever, or chills. The patient had normal sleep, appetite, urination, and defecation. The patient's tongue body was normal and the tongue was light red. The tongue coating was thin and white, and the coating was peeled off in the middle of the tongue, and the pulse was thready and rapid.,TCM disease and syndrome, Feiwei disease syndrome of qi deficiency and blood stasis,Western medicine diagnosis, Interstitial lung diseases,Therapeutic methods, Patient was treated with pirfenidone, prednisone, pantoprazole, and acetylcysteine, Xuefuzhuyutang and Sijunzitang were added and subtracted for treatment.,Clinical outcomes, The patient's dyspnea symptoms were relieved and the pulmonary dispersion function was slightly improved.
间质性肺疾病肺络通络
Interstitial lung diseaseLung collateralsDredging collaterals
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