仝小林教授从寒湿入营论治老年阴证白肺

Professor TONG Xiaolin’s experience in the treatment of white lung in elderly yin syndrome through cold and dampness into ying fen

关键词:  寒湿入营  瘀热入营  阴证白肺  破格子龙宣白承气汤

Key words:  cold and dampness into ying fen  stasis and heat into ying fen  yin syndrome white lung  Poge Zilong Xuanbai Chengqi Decoction

摘要:

寒湿疫乃感受寒湿戾气，以伤阳为主线，体质因素为寒湿化热入营的关键，与温病瘀热入营有明显区别。老年重症患者，因其免疫低下、正气抗邪无力，而临床症状不显，但结合影像学及检验学微观指标已见“白肺”、D-二聚体升高等征象，首当辨清寒热阴阳为要。治疗当审视全程，把握老年人“虚老态”为基，打破“白肺即炎症”“炎症即瘀热”的固有思维，予破格子龙宣白承气汤回阳救逆、活血通络、宣肺通腑，顾护阳气为要，以此补充营血分理论病机和对应治法方药，丰富其临证手段。

Abstract:

Cold and damp epidemic is feeling cold and damp hostility，with injury to yang as the main line and physical factors as the key to the cold and damp heat into ying fen，with a clear difference from the warm disease stasis and heat into ying fen. Elderly patients with severe diseases，because of their immunity，positive qi resistance to evil powerlessness，and clinical symptoms are not obvious，but combined with imaging and laboratory micro-indicators，have seen “white lung”，D-dimer elevation and other signs，first of all，should be identified cold and heat，yin and yang as the key. Treatment should examine the whole process，grasp the elderly “false old state” as the basic，break the “white lung is inflammation”“inflammation is stasis heat” inherent thinking. Using Poge Zilong Xuanbai Chengqi Decoction to resuscitate yang and prevent collapse，activate blood circulation，promote lung and pass internal organs，in order to take care of yang as the main point，so as to supplement the theory of the mechanism of the camp and blood points and the corresponding treatment methods and prescriptions，and to enrich the means of its clinical evidence.